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W SQUARED LT 2
W - quared Lot 2 #018-331-26 Municipality of Anchorage -. Development Services Department " y� Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number: 90 Oil O Iq& PID Number: I - 31 -Ato Name. Vi U lie rri c k Wastewater System: El New 9upgrade Address: 169 E Ave- ABSORPTION FIELD PhoneNumber of symoms: "J lyD`/ eep Trento D Shallow Trento O Bed ❑ Mound ❑ Olhar. I LEGAL DESCRIPTION soil Rating: / GPD/Fa Total Depth from original grade; f 0 Ft. Block: Lot: Snnubdwision:Depth to pipe bottom them original grade: 3 Gravel depth beneath pipe: �/ n J_0 / ec. —J v -ed Ft. I FI, Township' Range: Section: Fill added above original grade: Gravel Length: —0- FI. -5r0 FI. Well: El New ❑ Upgrade Gravel Mein: Number of lines: ( Distance behveen lines. — ,2 Ft. FI. Classification (Private, A. B, C): Total Depth:Cased to: Total absorption area: Pipe Material: Ft. FI. y / OO Fla _FV4, Driller. Data Dnlled: Static Water Level: Ft Installer. Dale Installed: (0/17/12 Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Fl. SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding PubliclPdvat Manufacturer. Capacity From Tank Field Station Tank Sewer Line Gal. Material: I ..b, Number of Compartments: Well Suns. Water1Vjp Njd N(� N(✓b LIFT STATION 1�11� Size: Marmfaclurec / Lal Lina 100 O /00 Gal. 'Pump on, level at: 'Pumpv� vel ac High water alarm at./ Foundalian /_ 7 9 � / /� ice/. in. in. Curtain Drain N l7 Kl1% Pump Make 8 Model Electrical Inspections penonned by: 1`( 0 0 Remarks: BENCH MARK Location and Description: (jDTTo1M 5iD/N Assumed elevation: 100 FL till -44 ®® I / 1°117% `l a Inspections performed by: �, . S. Dates: tat 2nd /1 /7710 silly'' A, � Development Services Department Approval 'R n?rdBlfSi9fl1 e Reviewed and approved by: Date: i ___________________________________ FARO TRENCH _ — — I I qi I 1 1 aUIED 1 SWW TTES i ST DARD I AC 69 FT :.: 50 LONG O8 8C 322 to DEP MARK Well 7 ERWTM m I 1 I ��� ;11 ` 49th °♦♦♦ ♦� %•••••TBB •••SPURKLAfiD•% ♦ No. CE0. 222251 ♦♦1♦ ssI :ice 25 0 25 _ 75 125 150 I SCALE, 10 i I Well TOBBEN SPURKLAND P.E. LOT 2, W -SQUARED SID SEPTIC SYSTEM AS BUILT 203 W 151H. AVENUE KEITH MERRICK DAT JUNE 22, 2004 (NCH. 99SHEET.23 GRID. 3135• 907 279-3916 11 11 � PERMIT # SW040196 PID # 018-331-26 V-200022,10WG ' "'CH INSULATION AfKaWWMOR 6' MIN — + AIR Ma ++ SAND BACKRU - + + + + f_ : + + Ij t 3 2 t + O t 5'-2" t t _r + 810CYCLE6000 STANDARD DRAIN FIELD 1-1/4 PVC WITH 1/6` MU AT 30' '� I TOTAL LENGTH 50 FT TOTAL DEPTH 10 FT TOTAL ROCK DEPTH 7 FT TOTAL COVER 3 FT 131 0-0 OOO°�°O O O SIT BARRIER O°O°°°O0000 0 °O°0.O°O°O°0°000°go O NO SCALE INSULATION TESTHOLf 82,© LEGEND. 1. PRIMARY TREATMENT, SEPTIC TANK 2. AERATION TANK J. CLARIFICATION TANK 4. DISCHARGE TANK 5. SOIL ABSORPTION 03 W th Ave /vu r.t. F SQUARE LOT 2 SEPTIC SYSTEM SCHEMATIC 203 W151h Ave 11 WASTEWATER SYSTEM SCHEMATIC DATE.• JUNE 22, 2004 A of Ak 99501 KEITH MERRICK SHEET.- 3/3 GRID. -.3 PERMIT t SWO40196 PID NO 018-331-26 W-20023.DWG 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 Initial Permit Number: SWO40196 Legal Description: LT"j4:# Design Engineer: 0007 Tobben Spurkland, PE Owner Name: Keith Merrick Owner Address: 1827 East 27 Avenue Anchorage , AK 99508-4018 L -17-o 4 if I2 -:00I Date Issued: Jun 17, 2004 Expiration Date: Jun 17, 2005 Parcel ID: 018-331-26 Site Address: 003931 DORA AVE Lot Size: 53855 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 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: 932M�ri Date: (P l7 2/ / Date: � t�-1o+) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci. anchorage.ak. us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. OIS-- 33 b Permit Number SW Property owner(s) V_ I=- tT-t} liA F-- R -a 1 C 14 Day phone Mailing address (1) Mailing address Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size 5 T 8 5 5- Acres/Sq.Ft. THIS APPLICATION IS FOR: Zip Code - _0 S. Number of Bedrooms Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade Pl*' 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. (Signature of property owner or autlfibrized agent) Permit Fees: S q/Waiver Fees: Date of Payment: �f i1/DDate of Payment: Receipt Number: �'J o 1 Receipt Number: (Rev. 12/00) T.SPURKLAND P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907)279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 2 W -SQUARED SAD KEITH MERRICK Municipality of Anchorage June 10, 2004 Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street Anchorage, Alaska 99519-6650 We are submitting an application for the upgrade of the septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable test holes are also enclosed. The septic system design is based on the following: Existing BioCycle system No Ground Water or Impervious Layer to 17 ft. Use Standard Trench Soil Rating. From Test Hole 06-07-04 32 min/in = 1 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 15011 = 150 sq.ft. Total area required: 150 x 4 = 600 sqft Bottom Rock At 10 feet Top Rock At 3 feet Rock Depth 7 feet Minimum Trench Length 600 / 14 = 42 ft. Use 50 ft SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 50 FT TOTAL WIDTH 2 FT TOTAL DEPTH 10 FT ROCK DEPTH 7 FT COVER 3 FT SEPTIC TANK Existing BioCycle The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. i i ----------------------------------- - — — — — — — — FAILED TRENCH 1 q0 1 I au I 1 sr 50 I I ID LONG O Well m 7 EFITEC FC7M ID xx 1 I I 1.��.....\\N,� 1 =•.� PSE At '`.49th ..... • ••ol �•• EN •SPURKLAND • • , 1� No, CE -2225 25 0 25 50•75 125 150 I SCALE.,1' = 0 i:.. I Well TOBBEN SPURKLAND P.E. LOT 2, W -SQUARED S D SEPTIC SYSTEM DESIGN 203 W 157H AVENUE KEITH MERRICK DATE.- JUNE 10, 2004 ANCH. AK. 99501 SHEET. 2/3 GRID.- 3135 907 179-3916 11 PERMIT # SV040xxx PID # 018-331-26 V-200022,DVG "',H INSULATION AR7COMPRLSSOR 6" MIN + AIR LINES SAND RACKTILL � + r + i 3 � •+ O i 5'-2" + BIOCYCLE 6000 1-1/4 PVC WITH 1/8' HOLES AT 30" I TOTAL LENGTH 50 FT TOTAL DEPTH 10 FT TOTAL ROCK DEPTH 7 FT TOTAL COVER 3 FT 00 0000000000 0 SILT BARWR 000000000000000000000 O _O_O_O_O_O_O_O_O_O_O_O_O_O_ NU SCALE INSULATION T£STHOLE LEGEND. 1. PRIMARY TREATMENT, SEPTIC TANK 2. AERATION TANK J. CLARIFICATION TANK 4. DISCHARGE TANK 5. SOIL ABSORPTION IIOHULN SPURKLAND P.L. I ( W—SQUARE LOT 2 I I SEPTIC SYSTEM SCHEMATIC 203 W151h Ave WASTEWATER SYSTEM SCHEMATIC DAA' JUNE 10, 2004 , ogf Ak 99501 KEITH MERRICK SHUT.- 3/3 GRID. 3135 PERMIT/ SW040XXX PID NO 018-331-26 W-20023.DWG Municipality of Anchorage Development Services Department Building Safety Division On -Site water and Wastewater Program U4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 w.wi ci anchoraoe.ak.us (907) 343.7904 Soils ills Log - Percolation Test °-r'o"ed For fA 6?-C'r1 a -- Dale Pe Lc- al Description: 1,01( Z el � VjNegpW Q'/n Township, Range, Section: Depth 2- j Se/a- 3- /� C 3 I 'S a,vtc Site Plan WAS GROUND WATER. 1 � E`1CCU`:TE=V� EO? S IFYES. AT 6'/HAT DEPTH? o Depth to N/aler After P Monitoring? / O E Dale: —_`- Fc COLaT10Fl HATE FERC HOLE DIA.LIETER b TEST RUNSEPMEEN !T717 FT AND FT '72—= -3 7- Ho+ -r= 14"A,S p2.r=SoAK rD �_E - ORMED BY. S I 1.5 'MCERTIF^( THAT THIS TEST bY::. S) DERFOREO IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE bo 10 r{ Gross Time NetTime Depth to water Ne' D•cp J 7 Y 3:4 WReadingDale 3= D 103 ;;� 3y I -7 1 1 A0 3 7 A Fc COLaT10Fl HATE FERC HOLE DIA.LIETER b TEST RUNSEPMEEN !T717 FT AND FT '72—= -3 7- Ho+ -r= 14"A,S p2.r=SoAK rD �_E - ORMED BY. S I 1.5 'MCERTIF^( THAT THIS TEST bY::. S) DERFOREO IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE bo 10 r{ Municipality of Anchorage Page of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: PID Number: DIB - 3 31- z b Name: LLA�) e i Wastewater System: '0 New ❑ Upgrade Address: t q,1 ABSORPTION FIELD Phone: No. of Bqrooms: DeepTrench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Boil Rating: Total Depth from original grade: f a GPD/SQ. Ft. Lot: /l Block: Subdivisi-0%J Depth to pipe bottom from original grade: Gravel depth beneath pipe „c- W- S (ALL re- o Ft. 7 Ft. Township: Range: Section: Fill added above original grade: Gravel length: 3 C) Ft. Ft. WELL: New ❑ Upgrade Gravel width: Numberof lines: Distancebetween lin `_ Fs JQ Ft. \ Classification (Private, A,B,C): — Total Depth: Cased To: 14 Total absorption area: Pipe material: +b`a.tc&,1-ec Laa P116 P-1 ig} Ft. Ft. SD. FL Driller: - Date Drilled: Static Water Level: Ins Iler: 03 Date installed: AL t= 3- —00 6-(0 Ft. V its Yield:Pump Set at: �,p Casing Height Above Ground: 4TANK Q GPM D B t 1-0 '\ Ft. ZFt. SEPARATION DISTANCES ❑ Septic ❑ Holding '>(S.T.E.P. TO Septic Absorption Lin HoldingPublic/Private Manufacturer: Capacity in gallons: t�o6't7 From Tank Field Station Tank sewer lines S OCYCLO' WCIh 14a a70 © Mateeriak _ IBf C-tLR Ss Number of Co partments: Watere NI0 Nto LIFT STATION p Lot Line go d %0 Size in gallons: lbw Manufacturer. Bit2CYtLE Foundation u "Pump on" level at: "Pump off' lev I at: High water alar at: �� Curtainj P11a ��t7 N Pump Make&Model Electrical Inspections performed by: Drain O Nt mfr UNI Remarks: BENCH MARK Location and Description: �e o�1n c tof 1 rid /y Assumed Elevation: O-A - '.ENF"a1�EER'S:'SEAL - 5 Soles Inspections performed by: Dates: 1st_ 2nd S 3 se T;, 'a Department of Health and Human Services approval Reviewed and approved by: Date: 72-013 (Rev. 9/91) MOA 25 / 4RD TRENCH: L£NGHT 30 FT DEPTH 1D FT WE ROCK 7 FT ,LE UNIT IIUtit1LN SYUKKLANU V.L. I I LOY' ? W-SQUARLU D I I SEPTIC SYSTEM AS MILT I 203 W 15TH. AVENUE ANCH. AK. 99501 �5 KEITH MERRIC DATE: JULY 28, 2000 /On7) 970_;01F SHEET- 2/3 GRID: 3135 PERMIT # SW990255 PID # 018-331-26 W-200022,DWG "';H INSULATION 6" WN SAND BACKFILL -�-i 5'-2' —, t t— AIRCOMPR£SSOR r. TOTAL �„_ LENGTH 30 FT IV c I TOTAL ROCK DEPTH 7 FT III COVER 3 FT STANDARD DRAIN FIELD 1-1/4 PVC WITH 1/8" HOLES AT JO" MTQ TOTAL �„_ LENGTH 30 FT TOTAL DEPTH 10 FT TOTAL ROCK DEPTH 7 FT TOTAL COVER 3 FT 981 I S IIII—III—III—III—III— I � �- 1=1 000 0 oo 00000o 0000vo_� SILT BARRIER 0 0 0 0 0 0 0 0 O`U ] O O O O O O O O O O" U O O O O O O O O O O O O"O �. ] 0 0 0 0 0 0 0 0 0-o„o„O-o„o �„_ BIOCYCLE 6000 INSULATION LEGEND: NO SCALE TESTHOLE 1. PRIMARY TREATMENT SEPTIC TANK 2. AERATION TANK 3. CLARIFICATION TANK 4. DISCHARGE TANK 5. SOIL ABSORPTION I103 W th AvLANU r. t. I I W -SQUARE LOT 2 I I SEPTIC SYSTEM SCHEMATIC I 203 W15Ih Ave WASTEWATER SYSTEM SCHEMATIC DATE: JULY 28, 2000 Anchorage Ak 99501 KEITH MERRICK SHEET- .3/3 GRID: 3135 PERMIT J/ SW990255 PID NO 018-331-26 WPERMIT SW990255 PID NO 018-33I -26 W-20023.DWGG Municipality of .Anchorage Department of Health and Human Services 825 "U' Street P.O. Box 196650 Anchorage, Alaska 99519.6650 Al Flick Mystrom http:/Awrw.d.anchorage. a k. us Mayor Permit Number: #SW 990355 Date of Issue: 9 -.Ob -99 Parcel Identification Number: 8D4-00 Date Started: 2-22-00 Date Completed: 3-1-00 Is well Iocated at approved permit location? Z Yes ❑ No Legal Descriptioy - ky SqrQd It 2 Property Owner Name & Address: Kieth Merrick 1827 East 27 Ave Anchorage, Ak 98508-4018 Borehole Data: Soil Type, Thickness & Water Strata stick-up organic - silt silty gravel gravelly silt sandy silt gravelly silt silt gravelly silt Depth (ft) From To 0 2 F 8 56 65 73 91 water sand and gravel 131 RECEIVED AUG 01 2000 O At. Healthl& of n HumanSari an 8 56 65 73 91 131 141 Method of Drilling 2 air rotary❑ cable tool Casing type: steel Wall Thickness: .025 inches Diameter: 6 inches Depth: 141. feet Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 88 feet Pumping level: 141 feet after 2 hours pumping 4O gpm Recovery Rate: 40 gpm Method of'resting: airlift Well Intake Opening Type: {� Open End [3 Opera Hole �] Screened Startfeet Stopped feet [] Perforations Start feet Stopped feet Grout'rype: bentonite # 3 _ Volume: I Depth: Start 0 feet Stopped n/a feet Pump: Intake Depth feet _ Pump size_ hp Brand Name _ Well Disinfected Upon Completion? Z Yes [] No Method of Disinfection: oloritte tablets Well Driller: Alpine Drilling& Enterprises P 0 Sox 110496 Anchorage AK 99511 Attention: The wet -drifter Mffjravide a well log to the property owner within 30 days of completion and the property rnw"Ar Ar tho wall 'IAifar chalk n0nv4Aa a .vPtl 1nry to #" rlant of 14a�10l R, ifnmon Qa n,ae tuithin 60 Anvc of rmm�l,.tinro T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Department of Health and Social Services 825 L Street Anchorage, Alaska 99501 Subject: Pending Approvals Lot 2 W -Squared Gentlemen; January 4, 2001 I understand that the "As Built' for the septic system installed on this lot has not been accepted due to a statement regarding the presence of bedrock. The testhole is reported as being 14 feet deep with the absorption trench 10 feet deep. The well log submitted by Alpine Drilling shows no bedrock or impervious materials to a depth of 141 feet. The septic system has been installed in accordance with State and Municipal regulations. qt� MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 Sly /o0 @ f'h-, 0C la) c ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SW990265 Legal Description: W SQUARED LT 2 Date Issued: Aug 05, 1999 Expiration Date: Aug 04, 2000 Parcel ID: 018-331-26 Design Engineer: 0007 Tobben Spurkland, PE Site Address: 003901 DORA AVE Owner Name: Keith Merrick Lot Size: 53855 SQ. FT. Owner Address: 1827 East 27 Avenue Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , AK 99508-4018 This permit is for the construction of: 0 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. 5. The following special provisions. THIS PERMIT ISSUED FOR THE CONSTRUCTION OF AN ALTERNATIVE BIOCYCLE WASTEWATER DISPOSAL SYSTEM. THE ATTACHED PROPERTY OWNER AGREEMENT SHALL BECOME A PART OF THIS PERMIT PACKAGE. Received By: Issued By: Date: '? Z Date: 9 —f—/f T.SPURKLAND IP. E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907)279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 2 W -SQUARED S/D KEITH MERRICK Municipality of Anchorage Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 June 30, 1999 We are submitting an application for a well and septic system installation for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the well and septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following : No Ground Water or Impervious Layer to 16 ft. Will be verified during installation Use Standard Trench with BioCycle Unit Soil Rating. From Testhole 04/17/98 10 min/in = 1.6 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 15011.6 = 93.75 sq.ft. Total area required: 93.75 x 4 = 375 sqft Testhole depth 14 feet Bottom Rock At l0 feet Top Rock At 3 feet Rock Depth 7 feet Total Trench Length 375 / 14 = 27 ft. USE 30 LF SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 30 FT TOTAL WIDTH 2 FT TOTAL DEPTH 10 FT ROCK DEPTH 7 FT COVER 3 FT BIOCYCLE UNIT The installation of this well and septic system will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. i — — — — — — — — — — IBM — — — — — — — — — — — — — aSSDMEIT ELFT! �OD.00 — — _ _ — — _ — — a 0 ry STANDARD TRENCH: B a mo V/ 49th 113EN SPURKLAND ,L\Lo CE -2225 ' %FESS��N��. 25 0 25 T+: ` '�6' ' ' N TOTAL LENGHT 30 FT A TOTAL DEPTH a++ �; 70 FT ...! N 'tO 90 "� EFFECTIVE ROCK 7 FT ra♦• ±� t' A f5 R£N BIOCYCL£ UNIT �S No v a J F N N N N N O o tN9 � B e o \\ 9N I IUtftrtry )I UMALANV P.L. 203 W 15TH. AVENUE LST 2, W- 5Q UIiRED SIDI SIDSEPTIC SYSTEM DESIGN ANCH. AK. 99501 KEITH MERRIC DATE: JUNE 30, 1999 (907) 279-3916 SHEET.- 2/3 GRID: 3135 PERMIT # S W9900XX PID # XX W -200022D WG FEB -09-40 WED 05:24 PN TOBBEN SPURKL-AND 2766013 P.02 I � i 194 193 L ---- --— VACANT —— _ — —_ --—— ---——————— — — — — -- i 7£SI 1R[NCN i I i 2 I 219OF i 1 i I "� i VAC41VT i ,........Y. . / 'A TOBa,N SPURKLAN➢�',r�� Nb. CE -2225 203 W 15TH, AVENUE H 1'V l /Y—bV uA1eBD SID SEPTIC SYSTEM DESIGN ANCH. AK. 99501 KEITH MERRIC DATE: ✓UNE 30, 1999 907 279-3916 SHEET., 113 GRID: 3135 PERMIT # SW990pXX PID # XX W-200021.DWG Well 223A VACANT 223E i I I I i so o so ioa !sa 200 250 ro SCALEt 1" = 190 f% 203 W 15TH, AVENUE H 1'V l /Y—bV uA1eBD SID SEPTIC SYSTEM DESIGN ANCH. AK. 99501 KEITH MERRIC DATE: ✓UNE 30, 1999 907 279-3916 SHEET., 113 GRID: 3135 PERMIT # SW990pXX PID # XX W-200021.DWG WD TRENCH: . LENGHT 30 FT . DEPTH 10 FT 71VE ROCK 7 FT 'CLE UNIT 203 WI 15TH. AVENUE L LUT iii-,5'YUAKPY) S/U SEPTIC SYSTEM DESIGN ANCH. AK. 99501 KEITH MERRIC DATE.- JUNE 30, 1999 /907) 279-3916 11 11 SHEET: 2/3 GRID: 3135 PERMIT # SW9900XX PID # XX 41-200022DWG I "',H INSULATION AIRCOMPRESSOR 6" MIN + AIR LINES + SAND BACKFILL + O 3 O + O + 5'-2» —' +11 1 BIOCYCLE 6000 P 49th HEN SPURKLAND QFES$IO��� STANDARD DRAIN FIELD 1-1/4 PVC WITH 1/8" HOLES AT 30" MTO TOTAL LENGTH 30 FT TOTAL DEPTH 10 FT TOTAL ROCK DEPTH 7 FT TOTAL COVER 3 FL n III-III-IIIIII-III-III- � � �-_ -11lI -_ X000000000000 O—c� SILT BARRIER 0 0 0 0 0 0 0 0 (1 D0 0 0 0 0 0 0 0 0 0 0 0 O O O O O O O O O O O 20,) v ,.,0„O„O„O„O�O„O�O„O„O,.,O„O�O v„ NO SCALE INSULATION TESTHOLE 14 FT. DEEP LEGEND, 1. PRIMARY TREATMENT, SEPTIC TANK 2. AERATION TANK J. CLARIFICATION TANK 4. DISCHARGE TANK 5. SOIL ABSORPTION W -SQUARE LOT 2 SEPT Anchoraqe Ali 99501 IC SYSTEM SCHEMATIC 203 W151h Ave WASTEWATER SYSTEM SCHEMATIC DA TE.- JULY 8, 1999 279-3976 11 KEITH MERRICK SHEET.- 3/3 GRID: 3135 PERMIT # SW990OXX PID NO XX W-200023.DWG Muni-tVality of Anchorage DEPARTMENT OF -IEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST ni pan spul"i1nd CC 2215 . . PERFORMED FOR: l� "L4.0—'r V—) C�� DATE PERFORMED: ��i`�a. •, ;"� V%I LEGAL DESCRIPTION: �B { p{„ �J{{'y Sp ukr* Township, Range, Section: D r oPL6,AWCy SLOPES SITE PLAN St" 14 2 ML 3 4 5 7 `S 8 9 10 �a 11 c _f 12- 13 K 14 — Be 15- 16- 17 5 i6 17 13 19 IF YES, AT WHAT DEPTH? De),Ih m Water Alter Monitoring) Date: ■■■■■■■■■■ S Date Gross J. —17_9 Time Net Time Depth to Water Net Drop ,k -S&AK :�o Daxin b z 3 0 '7 b® 5 l • i � t3 �s 20 PERCOLATION RATE /0 Iminutesnnch) PERC HOLE DIAMETER TLST RUN BETWEEN FT AND 3 X FT DISCLAIMER GrnundwatPr conditions indicated are fnr the dates shown only. Past and future presence &1ld/or depth of grot.ndwater can not be predicted rom t ese o serva ions. PERFORMED BY: —_ 'i:A _._._ I T. g - _ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIC ELINES IN EFFECT ON THIS OAT r". DATE: 72-008 (Rev. 4/85) Municipality of Anchorage *�� Development Services DepartmentBuilding Safety DivisionOn-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. COSA # Expiration Date:" �� U 1. GENERAL INFORMATION Complete legal description W- Sa acerX. LOS 2 Location (site address) . 3431 Doi -a.. AYeVRue- Current Property owner(s) Tece57. Nnnriscr% Day phone 24o- 64 90 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 3131 pora Air ,,e , P`v+ ae-awe I.AK 151ko Unless otherwise requested, COSA will be held by DSD for pickup. Day phone Day phone 2. NUMBER OF BEDROOMS: A 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [2 Individual On-site K Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of 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. Name of Firm ���tc rL`anc� Ensineen�nc Address 2A3 w . Y5 't Si_c Zo3 t AnJ,om;t=* Av nso Engineer's Printed Name _ Lacs SS, 5. DSD/SIGNATURE Y Approved for __q__ bedrooms. Disapproved. Phone 211 -310 - Date 115LO-t oF Ar t?. � ttlpllt�?sh-x Conditional approval for bedrooms, with the following stipulations: Attachments COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: wr�Original Certificate Date: qjujoy (Rev. 1 V05) foSa Municipality of Anchorage QpGE S4i Development Services Department 4 Building Safety Division a= On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.Muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. COSA# b1zy)52.1 Expiration Date: L 2-/-007 1. GENERAL INFORMATION Complete legal description Location (site address) _ 393/ l9or& Avenuc Current Property owner(s) I ece s z. Ha rriSo n Day phone 2 YO — 6 Y 90 Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Y 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site X Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of 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. Name of Firm .Snvekl nd 9 4;7 eo,n Address Engineer's Printed Name 5. DSD SIGNATURE Approved for T bedrooms. Disapproved. Phone 279-39/6 Date 8 lB o G .. 49TH; � ,..:.i. 9�• LARS E. PURKL.AND: cc �� �' 11500 •��� Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By:, " r (Rev. 11105) Original Certificate Date: 10 2, 1/ - Municipality of Anchorage • '� Development Services Department =e Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: W - 51wired LoT 2 Parcel ID: I rQ - 3 3 1 A. WELL DATA Well type/iv tc If A, B, or C provide PWSID # Date completed 302oao Sanitary seal (Y/N) Y_ Total depth M ft. Cased to N1 ft. FROM WELL LOG Date of test 3-1-00 Static water level $ (o ft. Well production y0 g.p.m. WATER SAMPLE RESULTS: Coliform_colonies1100 mL Nitrate O I mg/L Arsenic: .NO ppb dateofsample:$IYD(v l.,S. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size Iwo gal. Number of Compartments L1 Foundation cleanout (Y/N) Depression over tank (Y/N) Well Log (Y/N) I Wires properly protected (Y/N) Casing height (above ground)2 in. AT INSPECTION 8-iy-off H. S_ g.p.m. Other bacteria_ colonies/100 mL Collected by: Date installed 5-30 -oa Cleanouts (Y/N) High water alarm (Y/N) i Date of pumping 10 14 0(o Pumper M C Don 3A*5 RkArn q C. ABSORPTION FIELD DATA Date installed b 1� Soil rating .p.d./ft2 or ftZ/bdrm) �_ System type Pep (/6nc{� Length 50 ft. Width Z ft. Gravel below pipe ft. Total depth ft. Eff. absorption area OD ftZ Monitoring tube Depression over field Date of adequacy test 8 O% Results (Pass/Fail) Pf For 4 bedrooms Fluid depth in absorption field before test E&n. Water added 7sD gal. New depth sin. Elapsed Time: 30 min. Final fluid depth T in. Absorption rate >= 6Z g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) -iw A10 If yes, give date — D. LIFT STATION Date installed S 00 "Pump on" level at 25 in. Datum mom T24k E. SEPARATION DISTANCES Size in gallons 1600 "Pump off" level at YY A in. Cycles tested 3 SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 150 1 - Absorption field on lot 15,0 1 f Public sewer main NIA Sewer /septic service line 1 SO ' t Animal containment areas 50 t Manhole/Access (Y/N) High water alarm level at 2Zl/'2. in. Meets alarm & circuit requirements? Yes On adjacent lots 1001 ' I On adjacent lots 100 + Public sewer manhole/cleanout N A Holding tank Manure/animal excrete storage areas 100 t SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Is Property line�00r Absorption field 15'. 1 t Water main AtIA Water service line ZS Surface water Al o Wells on adjacent lots IDO i SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: I Property line GO Building foundation 1g Water main� �{ Water Service line Z 5 Surface water Al 0 Driveway, parking/vehicle storage ZS+ Curtain drain 'y Lo Wells on adjacent lots 1004 F. COMMENTS G. ENGINEER'S CERTIFICATION i� OF,A1`1 t certify that I have determined through field inspections and j9'�� review of Municipal records that the above systems are in 49TH conformance with MOA COSA guidelines in effect on this date. j Engineer's Printed Name G ZtfS Spv/hiaHrJ ?iK• LAR S .SP RKLAND.* j ,I� �Jj,•. t t�o0 ��00, Date il. �hont��ofnNP�',� COSA Fee Waiver Fee $ Date of Payment a �' Date of Payment Receipt Number �' SJ Receipt Number (Rev. 11105) U E W0Q 1 H w N ,n O 0 FC 0 V ' al �0, x Id, O �U DW �U W -) o Ww az wdcea� z xzoo Ea' Wo w w fs ] E W t¢� t - L O U[ � a hra N O 20 m W} W i' W H xaa H H ry WH !L OH F2000Y xzrz, HH x'2f . ii W H m `UQ UZ NS'> o2'H a Fi iE2��X Oi�i W Lca W El I4 w21FH p Z) V JU (Wj a �zw o FSP"w`<K z oiociw oa m O x OJoa H UHPE wE s_mxceano Kwwz0 Hw0 W (na (nom A z P 0 O P n o o o x Q WW Qa H' g 2 W W xwOw F�OKOO a HH,`.-iH w z HH O UW rtZ `��oH x Fg W W ZZ�rL2 (,) U W HooaoSzoiw U E W0Q 1 H w N JOE zzz M N I N O I O O U h ,n FC � al 0) x O r� x Q O r.� N a' --i �i N O x 0 0 CD U Q rn JOE zzz M N I N O I O O U h 193 o r r r 219 o r r r (164.63')164.64' ELECT. &_ TE LE CO ESNPP. UTILITIES ARE IN THIS EASEMENT / \ 8.1 X 12.1 SHED 5.3 DIA. WOOD FENCE O SEWER PIPE FIRE PIT DURING THIS SURVEY) C'O ��?Frq�rNG wAtts 77.3 /CONCRETE RETAINING CONCRETE RETAINING PLANTER - O SEWER PIPE ' �S10 d .L/Z SEWER PIPE A�gs�ii �j 49 i * T" G V 7 00 Bryan E. Cooper No. LS -5733 ,,,�a pm3FES51ON A� S'P�o �` Date signed (�/� U SEWER MANHOLE rs R9°5F'1R"F.1 219 COOPER AND COMPANY 148.81' \ (148.89') \ M TREE STAND 4 601 NORTHWOOD M (NOT LOCATED THIS AREA CD (N O SEWER PIPE DURING THIS SURVEY) C'O AS -BUILT CERTIFICATION (907)248-1924 rn N IN SCALE I HEREBY CERTIFY THAT I HAVE o M SURVEYED THE DESCRIBED PROPERTY HEREON AND THAT NO VISIBLE EN- ri 11/22/00 —.0 EXIST EXCEPT AS BEC INDICATED. —• GRID CHECKED BY EXCLUSION NOTE 00-05-13 IT IS THE RESPONSIBILITY OF THE _ OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR on M RESTRICTIONS WHICH DO NOT APPEAR - ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD o M ANY DATA HEREON BE USED FOR CON- STRUCTION OR FOR ESTABLISHING _ FENCES OR BOUNDARY LINES. AS -BUILT RECERTIFIED 9/8/06 COOPER & COMPANY PROJECT #06-09-27 a AS -BUILT RECERTIFIED 5/19/04 COOPER & COMPANY PROJECT #04-05-11 TREE HOUSE LEGAL DESCRIPTION LOT 2 W SQUARED SUBDIVISION 89054'44''W rs R9°5F'1R"F.1 COOPER AND COMPANY 148.81' \ (148.89') \ TREE STAND 4 601 NORTHWOOD (NOT LOCATED THIS AREA CD (N ANCHORAGE, ALASKA 99517 DURING THIS SURVEY) C'O (907)248-1924 N ATE SCALE DRAWN BY N L— 2 2 3 A 11/22/00 —.0 1" = 30' BEC N —• GRID CHECKED BY 00-05-13 3135 JBC NOTES: 1. THIS SURVEY WAS ACCOMPLISHED USING THE PLAT OF RECORD OF W. SQUARED SUBDIVISION (FILE #84.80 ANCHORAGE RECORDING DISTRICT, ALASKA) AND SURVEY CONTROL LOCATED DURING THE COURSE OF THIS SURVEY. ( ) INDICATES RECORD BEARINGS AND DISTANCES FROM THE RECORDED PLAT, FILE #84-80. 2. NO TITLE SEARCH WAS ORDERED OR PERFORMED FOR THIS SURVEY. 3. THIS AS -BUILT DRAWING IS NOT VALID WITHOUT THE SURVEYOR'S ORIGINAL SIGNATURE. 4. THIS AS -BUILT SURVEY WAS ORDERED BY KEITH MERRICK. 5. NOTE THE FOLLOWING ENCROACHMENT: THE GRAVEL DRIVEWAY INTO THE RIGHT OF WAY OF DORA AVENUE. 6. AT THE TIME OF THIS SURVEY, NOVEMBER 22, 2000, NO OTHER VISIBLE IMPROVEMENTS EXIST EXCEPT AS SHOWN OR STATED. MAY 19, 2004 7. ADDED BLOCK RETAINING WALLS, STEPS, CONCRETE, SHED AND THE WOOD FENCE. SEPTEMBER 8, 2006 8. ADDED SEWER PIPE, FIRE PIT, TREE HOUSE, A NOTE ABOUT A TREE STAND AND A RETAINING WALL/PLANTER. 9. THIS RECERTIFICATION SURVEY WAS ORDERED BY LARS SPURKLAND, P.E. 10. MISC. NOTE: 1) NOTE #4 DOES NOT APPLY NOW. 2) THE DATE IN NOTE #6 IS NOW SEPTEMBER 8, 2006. 3) ALL OTHER NOTES STILL APPLY. LOT 1 1 (164.63') 10' ELECT_& -TELECOMM. ESMT.UTI �T -'F- / \.,. 6.1 X 12.1 SHED O 5.3 DIA. FIRE PIT 77.3 WAQS / \ CONCRETE 0 .S O — rI �Is,�p RETAINING WALL I I I I I I I I I I I I I I I I I I I � I � I K I ® WELL I CONCRETE RETAINING WALL/% PLANTER - C/ O SEWER °54'44''W L-2237 Municipality of Anchorage 1�1'�PpGE 8Li • Development Services Department s Building Safety Division On -Site Water and 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 FOR A SINGLE FAMILY DWELLING Parcel I. D. rr 04iq7-S31 - 96 HAA # 040 0 Z1 -I Expiration Date: !3 -a5 --0_q_ 1. GENERAL INFORMATION Complete legal description L.o`i 2 W- 9060AP- b Location (site address or directions) 3931 �20 RA AV(;-:'-- Current Vl^Current Property owner(s) V E iTH t.4 m 9-2. tcy- Day phone 8166- boys Mailing address Lending agency Mailing address Real Estate Agent Mailing Address C Day phone 1) V,1 A RiZoj>i9TLIC P.V, Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 9 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 spousesy for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-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 bbe„ spv rk.la.kep Phone ,274-3416 Address ,2o 3 W/ 1 G!, jv2o3 Engineer's Printed Name _ i orabe" SRVV k1(k"a 5. DSD SIGNATURE __LZ Approved for _ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: ittttttt(f((rI//i�i yogi' Additional Comments -�2;. ON-SITE • , WASTEWATER :. PROGRAM ��u,.�rdyTSE�� •• ��JJI)I)1)1111 Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: (/�/1% /_ /� Original Certificate Date: G -2✓C- (Rev. 01102) Municipality of Anchorage _e Development Services Department Building Safety Division On -Site Water & Wastewater Program s" 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT 2 w— S' Q o&e C p Parcel ID of 8_ 33I -fib A. WELL DATA Well type K If A, B, or C provide PWSID # Well Log (Y/N) y Date completed3-1-00 Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to 141 ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test '3-1-60 g-a,1_oy Static water level 8r,6 ft. 195 ft. Well production 140 g,p.m. Lj 2+ g.p.m. WATER SAMPLE RESULTS: Coliform —colonies/100 ml. Nitrate N_ mg./l. Other bacteria colonies/100 ml. Arsenic: mg./I. Date of sample: S�:/ o y Collected by: 6ar;1e5.5 B. SEPTIC/HOLDING TANK DATA Tank Type/Material 810cG l,I is-Irip e rz a SS Date installed 5- 3 b - a Tank size /boo gal. Number of Compartments Cleanouts (Y/N) Y Foundation cleanout (YIN)� Depression over tank (Y/N) _N High water alarm (Y/N) N Date of pumping Aewier No s UA.,ot e. C. ABSORPTION FIELD DATA Date installed AL1710 V Soil rating (g.p.d./ft2 ) System type T'a~A Length 60 ft. Width Y, ft. Gravel below pipe % ft. Total depth to ft. Eff. absorption area 70D ft Monitoring tube _ Depression over field Date of adequacy test N& Results (Pass/Fail) For L bedrooms Fluid depth in absorption field before test ✓in. Water added--Z'gal. New depth k"'in. Elapsed Time: _✓min. Final fluid depth ✓ in. Absorption rate >= &ao g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) ✓ If yes, give date ✓ D. LIFT STATION Date installed '`l0 �0y Size in gallons 16 vd Manhole/Access (YIN) "Pump on" level at,2L in. "Pump off' level at / tr in. High water alarm level at 1/ in. Datum Cycles tested Y Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 160 f On adjacent lots 1004 Absorption field on lot y6 - D Public sewer main NIA Sewer /septic service line 150 On adjacent lots 1010+- Public sewer manhole/cleanout NSA Holding tank N SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation is Property line 1&0 Absorption field 15 Water main NZA Water service line ;25 Surface water N t o Wells on adjacent lots I0t'> + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 60 Building foundation 16 Water main N/A Water Service line o2$ Surface water %j In Driveway, parking/vehicle storage Curtain drain N u Wells on adjacent lots J" F. COMMENTS G. ENGINEER'S CERTIFICATION 'p��:.•"iO0 °•«.�@I 1 certify that t have determined through field inspections and y y review of Municipal records that the above systems are in .»...o...».a conformance with MOA NAA guidelines in effect on this date. Engineer's Printed Name T. S?v P -VA AIALt r0 " Date HAA Fee $ jyv y5o fir, Date of Payment Gla z/O y , Receipt Number sq V3 `i (Rev. 12101) Waiver Fee $ Date of Payment Receipt Number SUN -22-2004 11:25 RM T SPURKLRN➢ 907 276 6013 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN M N 1;A TY ANCHORAGE AND � (( P.01 THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this,/U�/�� day of � LP 20� � by and between � �� herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System Y_ (AWWTS), described as (�C�L(l located at 5`� ,1- Anchorage, Alaska. 2. Definitions. A. 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. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AhIC") 15.65 B. Certificate of On -Site Systems Approval. An approval by the lvlunicipality of cxisting water and wastewater disposal systems given ar the time of property sale and title transfer in accordance with AMC Page 1 of 5 JUN -22-2004 11:25 AM T SPURKLAND 907 276 6013 P.02 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. C. Damage, Any man-made or natural change in a system that would inhibit the system from performing as designed, D. 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, E, Permit (Construction). An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65, F. Permit (Operating). An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all requirements of this agreement, the conditions of the Operating Permit, the requirements of the On -Site Wastewater System Construction Pcrmit and all relevant provisions of AMC 15.65. 3, Fee. Owner shall pay to Municipality an annual fee of — G (S��.00), payable on or before the issuance of the operating permit and ann. ally thereafter. The annual fee is due on or before the anniversary date of the approval b. the Municipality of installed system. Raze of 5 JUN -22-2004 11:26 RM T SPURKLAND 907 276 6013 P.03 4. Term, The term of this Memorandum of Understanding shall be for the life of the AWWTS, The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of on site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional E ui meat. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. &laintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. in addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, owner agrees to comply with all applicable ordinances, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: Palle 3 of 5 JUN -22-2004 11:26 RM T SPURKLAND 907 276 6013 P.04 C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the systems. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way affect the validity of this memorandum of Understanding or'any part hereof, or the right of such party thereafter to enforce each and every provision hereof. R. Amendment. A. This Memorandum of Understanding shall only be amended, modified or chant*ed by a writing. executed by authorized representatives of the parties, with the same formality, as this Nlemorondurn of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. Pnee 4 of 5 JUN -22-2004 11:27 AM T SPURKLAND 907 276 6013 P.05 B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding 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 govem the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: t MUNICIPALITY: am By: . Title: Date: STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT The oregoin$ tstrument was acknowledged before me thisT y of 2004, by vu56k-, the t���^ %L of ;i l3i beh of - Municipality of Anchorage."-���" �r�'Newrr NOTARY Pli.il6�jititk�llfll�l� Passe 5 of