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VALHALLA BLK 3 LT 4
Valhalla Block Lot 4 3 #015-212-15 12IcI IR -.v 3/7AI MUNICIPALITY OF ANCHORAGE R} Iv\ �ic/511 I`I DEPARTMENT OF HEALTH &ENVIRONMENTAL PROTECTION G \` ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME / L PHONE GINEW .� (— aE.?'/i'b/`. ❑UPGRADE f.Wr i iy li i' i.� J /'.c /� MAILING DRESS— ' /953 LEGAL DESCRIPTION LOCATION Nd. OF BEDROOMS Well Absorption area Dwelling PERMIT NO. DISTANCE TO: Uy H Z _ Manufacturer Material No. of compartments aQ wf LIn. capacity in gatlons 2 l IF HOMEMADE: Inside length Width Liquid depth DISTANCE TO: Well Dwelling PERMIT NO. Z F Manufacturer Material Liquid capacity in gallons 2 ❑ Well u / Fondatiw Nearest lot line . PERMIT NO. w= DISTANCE TO: Ia `�+/ / to Z No. of lines Length of each line Total length of lines Trench width Distance between lines Zw — / .3 - inches X— x F __3_2 Top of tele to finish grade (Material beneath Tile/ Total effective absorption area ❑ Z/ / zz inches _37 `u Length Width Depth PERMIT NO. w O Q N Type of crib Crib diameter Crib depth Total effective absorption area w° w w Well Building foundation Nearest lo[ line DISTANCE TO: J Depth Driller Distance to lo[ line PERMITNO. [brISTANCE Building foundation � Sewer line Septic tank Absorption areasi / TO: 2 , OTHER PIPE MATERIALS SOILTEST RATING INSTALLER0 REMARKS t— I Y ROVED r DATE LEGAL 12IcI IR -.v 3/7AI December 31, 1979 Underground Ltd. Post Office Box 4-1953 Anchorage, Alaska 99509 Permit 4790155 Subject: Lot 4 Block 3 Valhalla Subdivision ..�KA99SUf A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer has inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. if there are any further questions, please contact this office at 264-4720. Sincerely, Les N. Buchholz,12.5. l-- Senior rnvironment:al Specie. st LNB/ljw enc: Copy of Permit .1 '1 lk� I I'll, r1f I 11� 11 11 I -H., 1 1-1 11 11 1INVII� l, 1 if I I I AE u.. I-IB".III I :, .1. vi I I I 1q, t. •J. it 1111. A 11IG-111 I I 1 1, F: 1, f- All ( [1-1 [-:J::T1) 1;4: 11.11, Ilia. D L, I I , H 111 I 11,:,[: 1 1 rIrd. I I .H1H )Ps:1 I 1 1: F i HrIf -1 —71,1 I—IF -1111: 1 —.7 01.41 P�.11 I I I III Yl I Flii I 111- M J.c, p.11.1 I-] 1 1:1 11 -1 je I 111: j:JRl: A , t:'IF PIII I III[ IF 011 V.1 :II R 11-1 1 1 :., 1 1.1 1-:, 1 , F: I 11") r t- H 11 j[: Iit11I `-II_L 1 I INIJ I I llf :1 1 F I I, IN 01 1111 [:"::ClA',.-T:1 1 11 f -IN 1 F -1 PITTH I lil,Pl- luill,fl I I.1 1;:. 1 F,i iia^::I :: 1:1-. I 1 1.P-11 k, 1,1 11 ll, I , 1 ia -, III 1 * I - I I - I I 11 :, I I p I t it 'Al :,I:: I' "1"'r' 11 11 - 11 1 .:0.1111i N 1 1-111 1:T S 01J.1f US 1 f If it -1 1 lr�, I-.11=:1 1, 1-111 LA F 1: 1 it it [I li 11 1, - it l r nN. - - -. �- A It . , 1, it If I ith: I I f: H W I I -K H, I I J [,Ill: llI I I CA"! AND f:it F,RI -.)f 11 1 Y I I I I X01 -� 70 Ms`s` R&M CONSULTANTS, INC. 5024 CORDOVA 6 BOX 6087 Y ANCHORAGE, ALASKA 99502 9 PH. 907-2]9-0.183 • TL%. 090-25360 4NNEHS SURVEYORS April 30, 1979 R&M No. 951119 Underground Ventures Ltd. P.O. Box 4-1953 Anchorage, Alaska Attention: Thomas Worden Subject: Soil Investigation for Sanitary Sewer System; Don Dahl Property, Lot 4, Block 3, Valhalla Subdivision, Anchorage, Alaska Dear Mr. Worden: At your request of April 23, 1979, we conducted a subsurface soils investi- gation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Municipality of Anchorage Department of Health and Environmental Protection. This investigation, which was accomplished on April 27, 1979, consisted of a test pit excavated to a depth of 19 feet below the existing ground surface. The test pit was sited according to your instructions and its location is shown in attached Drawing A-01. Excavation was accomplished with a Drott 40 backhoe. All material excavated was continuously monitored by an experienced engineering geologist. The topography at the excavation site is generally gently -sloping to the west. At the time of the investigation the site had original vegetation consisting of 8 inch diameter birch and spruce and alder thickets. The top of the test pit was located at original ground surface. The soils encountered in the excavation are shown in the test pit log in. Drawing A-01. This log displays specific conditions encountered at the test location. However, subsurface conditions may vary in other parts of the lot without any apparent surficial evidence of the change. Groundwater was not encountered and bedrock was not encountered. At the time the pit was excavated seasonal. frost was not present and permafrost was not encountered. A percolation test was performed in a 2 -foot hole at the depth of 6 feet in an adjoining test pit. The data in Table 1 show average infiltration from the depths indicated to the bottom of the hole. The measured percolation rate was 13.3 minutes per inch. A11C11RAC. VNC111 VALOEL .4A-.ILIT We appreciated this opportunity to be of service to you. Please contact us if you have any questions concerning this letter or if we can be of addi- tional service. Very truly yours, R&M CONSULTANTS, INC. Ernest R. Rahaim Staff Geologist ERR:GS/rm/AT&SI-C S4Ga Se for Geologist BORING NUMBERTP_3 Date Completed: 4-30-79 LL =w F N i ag SOIL DESCRIPTION a o d¢ v¢ Ss,72,57.I%,85.9 pcf "DRY' DENS/TY L L NATER CONTENT f o~.v° ORGANIC MATERIALL_OL_ .5' BLOWS/FOOT o SAMPLER TYPE SILT W/SOME GRAVEL, SOME ° SAND, GM W D. WATER TABLE - scattered co�pl�2' -Z APPROK STRATA CHANGE �( BEDROCK GRAVELLY SAND W/SOME SILT, GM '•o scattered cobbles e• p o' e. 5 O'• •O o. GRAVELLY SAND W/SOME SILT, GM �• 0 occasional cobbles to o• o C 0-- •13' 13' •e•o' •,'• ;o SILTY SAND W/SOME GRAVEL, SM o ,P °•' SANDY SILT W/SOME GRAVEL, ML scattered cobbles 19'T.D 20 LOCATION SKETCH No Scole Lot 5 ro ro -T-0- 40 0'o' Test Pit 3 .c 10,Lot 4 co NOTE: DISTANCES SHOWN ARE APPROXIMATE AND HAVE NOT BEEN MEASURED BY SURVEYING METHODS. EXPLANATION r UN i OZ GROUND `FROZEN GROUND WD-WH/LEOR/LL/NG _TYPICAL SOILS LOG AB -AFTER BOR/NG Ss /4 SPLIT SPOON WITH 140 LS HAMMER S x /.4 SPLIT SPOON/ 1VITH 340 LB. HAMMER Sh 25 " SPL/T SPOON WITH 340 LB HAMMER SP 2.5' SPLIT SPOON, PUSHED A AUGER SAMPLE Ts SHELBY TU3E T. MODIFIED SHFLBY TUBE Bs BULK SAMPLE SAMPLER TYPE SYMBOLS _ A GRAVEL AfRI ORGANIC 0/AY COBBLES D BOULDERS SILT ® BEDROCK SAND - ICE MASSIVE SOIL SYMBOLS OWN. _E E.R.R. n Lot 4, Block 3 -B _ CKD._ _ ;�F,M CONSULTANTS, INC. I Valhalla Subdivision GRID. 2736 DATE. 4-30-79 °�E�n9 fEO1OG1bT6 Anchorage, Alaska RRoa.No_951119 - NNEvs 5°a„E.�Na — S SOILS LOC OWG.NO SCALE. ��qaq ORGANIC RIAL Little Visible INC 0 V K A.B. �-/CE DESCRIPTION - ° o.. SAMPLE NUMBER $q bna a Ss,72,57.I%,85.9 pcf "DRY' DENS/TY L L NATER CONTENT f p @ BLOWS/FOOT SAMPLER TYPE W D. WATER TABLE - -Z APPROK STRATA CHANGE �( BEDROCK OWN. _E E.R.R. n Lot 4, Block 3 -B _ CKD._ _ ;�F,M CONSULTANTS, INC. I Valhalla Subdivision GRID. 2736 DATE. 4-30-79 °�E�n9 fEO1OG1bT6 Anchorage, Alaska RRoa.No_951119 - NNEvs 5°a„E.�Na — S SOILS LOC OWG.NO SCALE. PERCOLATION TEST Table 1 R&M NO. 951119 Time Elapsed Time Inches Drop in inches 10:04 0 0 ' 1 1.25 1.25 3 2.25 1 5 2.75 .50 10 3.25 .50 go 13.33 minutes per inch 7 � / v --� 15 ��o 34 Y 4.50 r 7g 46 5.25 .75 Iu 50 6.25 % 60 6.75 .50 2.25 inches 13.33 minutes per inch 7 � / v --� 15 ��o liar L. 3I@BQ; % SSC t lRQnurri. A Aw curcou8AGa:9 A ILAF4 KA 00302 �414Im'�'i ill• SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF LU DRILLED AT THE RATE OF 918.50 PER FOOT. /1 PROPERTY OWNER LOCATION OF WELL DRILLER Byuuc Gtattt'd a-� RmLpa U1.rk l a2kA. WELL LOG: 0----34' �c t and 4 l t. J, c tay )jt 34-_-95' Sttt.k 3an4 gw.uU, we,t w.i.th 3001- cLcrd ------ --- --- -------------------- 95---734' Wet cfau.. 75% aanV4 rw.te�riaL. no vtaue.L. 134-169' HaAdpaa. 169-170' good Cl.e= bYatet bewiinq Vmuei with a Wtoducit-fon, 4 10 9XI w-i.ih 30 4et oj� wa to t 4 tand %n ca4a4. 1/2 flo&.�e Su ,& pwap 4h ou td be d" to ied .l ure .deet ag bottonL. 4 Itoo.t e-xte" i.oa added to the. 170 . ce,t: Ouv4 ye: $28.00 Ro CJzav4e- A -t WeU Seal.. COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 93173.00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE Illwi, 15.th., 1979 SERVICE CHARGE OF 1 Y.% PER MONTH WILL B ASSESSED ON PAST DUE ACCOUNTS. 5. LEGAL D,ESCRLI`PTIONF/� D -i E RECEIVED INSPECTION APPOINTMENTS —Al1 .. 71"1E TIME TIME NUMBER OF,BEDROOMS —✓ SINGLE FAMILY ❑ One O Four ❑ Other Two ❑ Five DATE DATE - DATE ATTACH WELL LOG. A well log is required for all wells drilled COMMUNITY A INSPECTOR INSPECTOR INSPECTOR � MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE ` DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALIil 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PI.O rECTION I �I C> YEAR ON SYSTEM WAS INSTALLED. ENVIRONMENTAL SANITATION DIVISION �r"' 1981 \�I Telephone 264.4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEVVakC4�tl 1V(SD DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. PP.OPERTy ?'.%NER �!0 LQ_ -n 1�2,� 1%�-any _5 MAILING ADDRESS PROPERTY RESIDENT (if di(feren4 from above) - PHONE 2. BU YFR1 p —c—> 4ti���tit tV LL -JL4 c� �c7 vL PHONE 5/��� ��1� MAILING ADDRESS 3. LENDING I STITUT ON i s PHONE/ �-�i-�LX't-�-��1 I MAH-rG ADDRE j 1 4. RFPLTOR AGENTj PHONE MAILIN ADDRESS—T r 5. LEGAL D,ESCRLI`PTIONF/� C 1r_ -'L - t- 'LCL -L t "O STREET LOCATION —Al1 .. 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS —✓ SINGLE FAMILY ❑ One O Four ❑ Other Two ❑ Five f 1 MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* ATTACH WELL LOG. A well log is required for all wells drilled COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) B. SEWAGE DISPOSAL SYSTEM �w INDIVIDUAL/ON-SITE., I �I C> YEAR ON SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EAC14 REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) �-0 0 /yam �U"E„ C/ THIS SIDE FOR 017FICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER '-;Septic Tank or ❑Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank 'Absorption Area L Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS I APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY -----�--- 72-010 (Rev. 6/70) �ulF 1. "'LAU, .V.� October 15, 1981 ,U 71�f;.:tl1 William Smith Star Route A Box 1581-E Anchorage, Alaska 99507 Subject: Lot 4 Block 3 Valhalla Subdivision Approval for the individual sewer and water facilities cannot be granted until the following item has been completed: (1) The water analysis report needs Co be submitted to this office from the Chem Lab, 5633 B Street for our review. If there are any further questions, please call this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/ljw cc: First Federal Savings and Loan Post Office Box 4-2200 99509 Rita Rosenberg % Re/Max Properties 2702 Gambell StreeC 99503 ,�yya-e�eli:�4a I " O 9. LEGAL DESCRIPTION MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF i'::ALTH & 825 L Street - Anchorage, Alaska 99801 ENVIRONMEl\L---.!_ ,-,;;..-i FCTION I, ® ENVIRONMENTAL ENGINEERING DIVISION `FR 51980 Telephone 264-4720 ❑ MULTIPLE FAMILY REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWERIEAIGI 7. WATER SUPPLY DIRECTIONS: Complete all parts on page 1. Incomplete requests will not he processed. Please allow ton (10) days for processing. 1. PROPERTY OWNER y— *ATTACH WELL LOG. Awell log is required for all wellsdrilled PHONE since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) MAILING ADDRESS ** �_ —-INDIVIDUAL/ON-SITE **If individual/on-site, give installation date 5-t tivWV7u"'� Aj7�' I PROPERTY RESIDENT (If different from above) If system is over two (2) years old an adequacy testis required PHONE 2. BUYER NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN 13E INITIATED, PHONE MAILING ADDRESS 3, LENDING INSTITUTION S PHONE c�•(IV�t MAILING ADDRESS � /'0 2-(C-41tCL2C,( \L - �� o s-�r ��Q 4. REALTOR/AGENT / r- ��`%�/f✓%/ ci/7�'C�l'l PHONE ����_�%�3 1- Dcial t'f% J MAILINGADDRESS _ " O 9. LEGAL DESCRIPTION STREET LOCAI ION hI 6. TYPE OF RESIDENCE NUMBER OF BEDHOUMS (11 U ---SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY 0' Three ❑ Six 7. WATER SUPPLY W --INDIVIDUAL* *ATTACH WELL LOG. Awell log is required for all wellsdrilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 6. SEWAGE DISPOSAL SYSTEM ** �_ —-INDIVIDUAL/ON-SITE **If individual/on-site, give installation date 5-t tivWV7u"'� Aj7�' I ❑ If system is over two (2) years old an adequacy testis required PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN 13E INITIATED, 72010(3/78) THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE= FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic Tank or El Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Lino Nearest Lot Line _ Absorption Area to nearest Lot Line 5. COMMENTS [ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE \ BY (Title) t} LEGAL DESCRIPTION 72-010 (Rev. 3/78) Municipa% of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS JUL 21 2016 )'K N Parcel I.D. 015-212-15 Expiration Date: 1. GENERAL INFORMATION Complete legal description VALHALLA; BLOCK 3, LOT 4 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 12231 SHILOH ROAD *ANCHORAGE, AK DANIEL & CYNTHIA BUCHSBAUM Day phone 12231 SHILOH ROAD *ANCHORAGE, AK LINDWOOD PARKER Day phone 884-6255 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ WaiverNodance request for. IV / A Distance: / I Received by: �� / Date: 2 1 COSA to be released to the engineer, unless otherwise requested by the engineer. 0 COSA Fee $ 5oq k S 1 J (, R, -L, Waiver Fee $ Date of Payment 7/2-t1 I� Date of Payment Receipt Number () d �ci) Receipt Number COSA # 65U U 30 3 Waiver # t. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my sedj 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. 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. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 `ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineers Comments: In conducting this evaluation, GEG provided an engineering evaluation of the well andlorseptic system in accordance w#h the guidelines and regulations establkhedby the MunicipaldyolAnchorage and indusfrymacfices. The repoded results desribe the camiilion of the systoWs on the date/sof the evaluation. Sepamgoa distances were measured to madgyidentffiable features Hidden defects orencroachments mayexisf that were not identified during the evaluation. The operatiamugle ofall wellsand septic systems depend on a variety of variables fncluding, but not limited to, soil conditions, grouadwaferlevels (that may fluctuate during the year), qualify of construction (materials and workmanship), and the water usage of the family utilizing the systenJs These conditions can vary, and are oulside the confrol of GEG. Satisfactory test results do not guarantee future performance of systems therefore, GEG makes no warranty (express orimplied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well orseptic system can be installed on the property in the event either of the ow ent systems fail. The content of this report is for the sole benefit of the penon pany who retained GEG. Reliance upon the information provided in this report by any otherperion orpary,, including but not limited to svbsequentproperfy purchasers, is not authorized. In short. GEG disavows any legal duty to anyone other than the person1party who paid for this report. 6. DSD SIGNATURE System #1 Approved for _2 bedrooms. $t 4�LG Bw System #2 Approved for bedrooms. Disapproved. OFA/V6" Conditional approval for bedrooms, with the following stipula*s: 'P5 . J ON-SITE �. WATER AND r" WASTEWA Original Certificate Date: 7-2 i The Municipality or Anchorage Develop,emt 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 10112112) If more than 1 septic system Is on the lot: COSA Checklist # _of_ Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: VALHALLA; BLOCK 3, LOT 4 Parcel ID: 015-212-15. A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 5/15/1979 Sanitary seal (Y/N) YES Total depth 170 ft. Cased to 170 ft. FROM WELL LOG Date of test 5/15/1979 Static water level 140 ft. Well production 10 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: ND<5 ug./L. B. SEPTIC/HOLDING TANK DATA' Nitrate 0 mg./L. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 7/18/2016 81.1 ft, 6+ g.p.m. Collected by: GEG. Ltd. Date of sample: 7/2016 37 YEAR OLD STEEL SEPTIC TANK IS APPROACHING THE END OF ITS USEFUL LIFE Tank Type/Material SEPTIC/STEEL Date installed —1979 Tank size 1250 gal. Number of Compartments 2(ASSUMED) Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping 7712/2016 Pumper MCDONALD'S PUMPING SERVICE= C. ABSORPTION FIELD DATA Date installed —1979 Soil rating (g.p.d./ftlor /bd 185 System type TRENCH t Length 32 ft. Width 3 ft Gravel below pipe 11 ft. Total depth_ ; * 1 ft. Eff. absorption area ***�37 fe. Monitoring tube YES Depression over field NO Date of adequacy test 7/18/2016 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption field before test 14.5 in. Water added 736 gal. New depth 41.5 in. Elapsed Time: 120 min. Final fluid depth 30.5 in. Absorption rate 54= : 450+ g•p,d Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date **PER INSPECTION REPORT D. LIFT STATION Date installed Size in gallons Manhole/Acoess (Y/N "Pump on" level at in. "Pump off" level A_t.====, . High water alarm level Cycles tested - Meats alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot •79 On adjacent lots 100'+ Absorption field on lot *90 Public sewer main 75'+ Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/deanout 100'+ Holding tank 75'+ I Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surrace water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parldng/vehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS SEE ATTACHED 411111111 G. ENGINEER'S CERTIFICATION SEPTIC SYSTEMS TO EAST AND I certify that I have determined through field inspections and review of Munielpai records that the above systems are in conformance with MOA COSH guidelines In effect on this date. Engineer's PrinteJd Name JEFFREY A. GARNESS Date V ftp (Rev. 11/05) IF Jq,*,Gc Bl6 N' Municipality of Anchorage • '� Development Services Department tri F' Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 4t www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-212-15 COSA# /I CS ell 912 340 / 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address VALHALLA S/D; BLOCK 3, LOT 4 12231 SHILOH ROAD * ANCHORAGE, AK * 99516 SCOTT EVERS Day phone 952-9702 12231 SHILOH ROAD * ANCHORAGE, AK * 99516 Day phone FELICITY WILLIAMS W/ KELLER WILLIAMS Day phone 841-2807 101 W. BENSON BLVD, #503 * ANCHORAGE, AK * 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site N 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 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, f 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 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, L1D. 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. DSDSIGNATURE V Approved for —3 bedrooms. Disapproved. Phone 337-6179 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: a � Original Certificate Date: s (Rev. 11105) r-7913 ON-SITE WATER AND WASTEWATER PROGRAM Municipality of Anchorage 5 Development Services Department Building Safety Division ` sn. rr• s 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: VALHALLA S/D; BLOCK 3, LOT 4 Parcel ID: 015-212-15 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 5/15/1979 Sanitary seal (Y/N) YES Total depth 170 ft. Date of test Static water level Well production Cased to 170 ft FROM WELL LOG 5/15/1979 140 ft. 10 g.p.m. WATER SAMPLE RESULTS: Coliformy colonies/100 ml. Arsenic:') 0 ug./L. B. SEPTIC/HOLDING TANK DATA Nitrate N r mg./L. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 6/5/2012 Date of sample: 6/5/2012 Tank Type/Material SEPTIC/UNKNOWN 80 ft. 6.02 g.p.m. Collected by: GEG, Ltd. Date installed 1979 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping Pumper /uC Jur) o. (C S C. ABSORPTION FIELD DATA BELOW EXISTING GRADE **PER INSPECTION REPORT. Date installed 1979 Soil rating (g.p.d./ftor /bdrm 1185 System type TRENCH Length 32 ft. Width 3 ft. Gravel below pipe 11 ft. Total depth *14.1 ft. Eff. absorption area **737 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 6/5/2012 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 24 in. Water added 885 gal. New depth 50 in. Elapsed Time: 1 EO min. Final fluid depth 36 in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN "Pump on" level at in. "Pump off' level ' . High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO Septic tank/lift station on lot . *79 On adjacent lots 100'+ Absorption field on lot *90 On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *PER EXISTING WAIVER G. ENGINEER'S CERTIFICATION i certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 6/1 cl'I 2 COSA Fee $ q96. w Date of Payment 61200 _ Receipt Number 0 U-7"4 (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number 'Oro felsaO�'- Municipality of Anchorage .° • -tel Development Services Department 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 n n FOR A SINGLE FAMILY DWELLING Parcel I.D. (�/S`- or / a� ' S COSA# t��3 1. GENERAL INFORMATION Expiration Date: --- Complete legal description VALHALLA S/D: BLOCK 3. LOT 4 Location (site address) 12231 SHILOH ROAD • ANCHORAGE. AK ' 99516 Current Property owner(s) SCOTT & JENNIFER MCDONALD Day phone 512-809-7595 Mailing address Lending agency Mailing address 12231 SHILOH ROAD • ANCHORAGE. AK • 99516 Day phone Real Estate Agent DAR WALDEN W/ KELLER WILLIAMS Day phone 865-6406 Mailing address 101 W. BENSON BLVD. #503 • ANCHORAGE, AK • 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well — -- -- Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ 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 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 engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity 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 ofAnchorage riles 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. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 21V40 Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysts of the system In accordance with ADEC and MOA DSD Guidelines G 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 file 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 fisted 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 �Z Approv Conditional approval for Attachments: / COSA Checklist [/ Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report ONSITE WATER AND WASTEWATER • PROGRAM Nitrate Advisory Other By: `'v' Original Certificate Date: (RH. 11851 Municipality of Anchorage • Development Services Department 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: VALHALLA S/D; BLOCK 3, LOT 4 Parcel ID: D /5_- 2. /2-/S A. WELL DATA Well type PRIVATE If A, B. or C provide PWSID# N/A Date completed 5/15/1979 Sanitary seal (Y/N) YES Total depth 170 ft. Cased to 170 ft. FROM WELL LOG Date of test 5/15/1979 Static water level 140 ft. Well production 10 g.p.m. WATER SAMPLE RESULTS: Well Log (YIN) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 2/12/2010 88 ft. 6 g.p.m. Coliform/Q_ colonies/100 ml. Nitrate' °• 1 mg./L. Other bacteria © colonies/100 ml. Arsenic: y,»ug./L. Date of sample: 2/12/2010 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/UNKNOWN Date installed 1979 Tank size 1250 gal. Number of Compartments UNKNOWN Cleanouts (Y/N) YES Foundation cleanout (YIN) YES Depression over tank (Y/N)N3 High water alarm (Y/N) N/A Date of pumping 2/12/2010 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA oW EXISTING GRADE Date installed 1979 Soil rating (g.p.d./ft'o /bd 185 System type TRENCH Length 32 ft. Width 3 ft. Gravel below pipe 11 ft. Total depth +14 ft. Eff. absorption area 737 ft' Monitoring tube YES Depression over field NO Date of adequacy test 2/12/2010 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test E In. Water added 630 gal. New depth 20 in. Elapsed Time: 150 min. Final fluid depth13 in. Absorption rate >= 450+ g,p-d- Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed "Pump on" level at in. E. SEPARATION DISTANCES Size in gallons Manhole/Access "Pump off" level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankA!ft station on lot *79 Absorption field on lot *90' Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *PER EXISTING WAIVER, #WR050025. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date -7-/73/fn u ore a m-• o COSA Fee S 'y go Date of Payment 2 - . 2 3-/0 Receipt Number 0 S ! 02 (Rev. MCS) Waiver Fee $ Date of Payment Receipt Number v q SGS Ref.N 1100525001 Client Name Gamess Engineering Group, Ltd Project Name/N Valhalla B3,L4 Client Sample ID Valhalla 1)3,L4 Alam: Drinking Water Sample Rcmarks: Printed Dmte/Time Collected Date/time ReceMed Date/Time Technical Director 0222/2010 12:53 02/1212010 12:30 02/122010 13:05 Stephen C. Ede Allowable Prep Analysis Parameter Results LOQ Units hlcdtod Contama ID Limits Date Date Init Metals by ICP/MS Arsenic 5.00 U 5.00 ug/L EP200.8 C (<10) 02/15/10 02/17/10 SCL Haters Department Total Nitratc/Nitritc-N 0.100 U 0.100 Microbiology Laboratory Colony Count 0 Total Coliform 0 Fecal Coliform 0 mg/L SN1204500NO3-F D (<10) col/l00mL SN1209222B col/100mL SN1209222O col/100ml. SA120922211 A (<200) A (<I) A (<I) 02/19/10 LCE 02/12/10 SDP 02/12/10 SDP 02/12/10 SDP 04b 13 10 08:00a m to f Bill McDonald (907) 337-0558 p.1 Mc2lonafc!'s Ptempiny Service 5432 E. Nonhern Lights Blvd, Suite #466OD Anchorage, Alaska 99308 �s (907) 338-4476 Invoice #6559 Tu; / r Dm . ate of SrMcr. Phone: Cummer t!O. Number. Conma Poron: Description Price uav Amount Septic tank pumped Sludge in tank Leach treatment Bio -mat in leach Dater level in leach Cap on Stand Pipes Other: Recommendations: Total 1.5% Interest u il/ be charged month!;, on unpaid bilis until paid. C Municipality of Anchorage Development Services Department % Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 _ v www.ci.anchorage.ak.us I S S UP- / or— (907) 343-7904 4A A -4t- O S70 g 6 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. lrj HAA#_ fhE5Q(W,- 1. GENERAL INFORMATION Expiration Date: _i is A& Complete legal description VALHALLA SUBDIVISION: LOT 4, BLOCK 3 Location (site address or directions) 12231 SHILOH ROAD * ANCHORAGE. AK 99516 Current Property owner(s) SHAWN STEPHAN Day phone c/o AGENT Mailing address c/o CARLA STEPHEN w/ PRUDENTAL JACK WHITE Lending agency Day phone Mailing address Real Estate Agent CARLA STEPHEN w/ PRUDENTIAL JW Day phone 242-5340 Mailing address 3801 CENTERPOINT DRIVE • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 seat axed 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 typo of structure Indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and Municipal tion, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all applicableP 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, SURE 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 li Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following Phone 337-6179 Date o LI -os- of � SITE � • �n= HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By:A=� Original Certificate Date: ° (Rev. 12101) Municipality of Anchorage ' Development Services Department BulkIft Safety Division Onsite water 3 wastewater Program 47W South emgaw SL P.O. Box 196850 Anchorage. AK 99519-8850 www.ei.andarage.ak.us (907)343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: VALHALLA SUBDIVISION* LOT 4 BLOCK 3 Parcel ID:_ pr_C--Z/ r -ir A WELL DATA Well type PRAA7E If A. B. or C provide PWSID# N/A Date completed 5/15/1979 y seal (YM) YES Total depth 170 ft. Cased to 170 ft. FROM WELL LOO Date of test 5/15/1979 Static water level 140 ft, Well Log (Y/N) YES Wires property Protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 4/7/2005 77 ft, Well production 10 g,p,m. 5.7+ g.pAn. WATER SAMPLE RESULTS: Colitonn 0 coionies/100 ml. Nitrate 0.1 mgiL1 Other bacteria 0 colonies/100 mi. Arsenic: N/A mgA. Date 10/410 2003 sample: 003 Copes by: GEG. LtD. B. SEPTIC/HOLDING TANK DATA Tank Type/Matedal UNKNOWN Date Installed -1979 Tank size 1250 gal. Number of Compartments 3 Cleanouts (Y/N) YES Foundation cleanout (YM) NS Depression over tank (YM) NO High water alarm (YM) N/A Date of pumping - 4/7/2005 Pump MCDONALDS PUMPING C. ABSORPTION FIELD DATA Date installed -1979 Soil rating (g.p.dJft'o Ibdrr 185 System type TRENCH Length 32 ft. Width 3 ft. Gravel below pipe 11 ft. Total depth •14 ft. EB. absorption area 737 ft' Monnorin tube � g Depression over field NO Date of adequacy test 4/7/2005 Results (Pass/Fan) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 1011gal. New depth 44 in. Elapsed Time: 130 min. Final Aub depth 27 in. Absorption rate >: 450+ g.p d. Any rejuvenation treatment (past 12 mo.) (Y/N 3 type) NONE KNOWN If yea. give date - D. LIFT STATION Date installed -pump on' level at _in. size in gallons High water alarm level at h• n tCydea tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tenMift station on lot +79' On adjacent lots 100'+ +9p' On adjacent lots 100'+ Absorption field on lot - Public sewer main N/A Public sewer manhole/desnout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property Une 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 1000+ Wells on adjacent lots001 '+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property Une 10'+ Building foundation 10'+ Water main N!A Water service line 10'+ Surface water 100'+ Driveway. Parldng/vehide storage --Lf Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS 0. ENGINEER'S CERTIFICATION I cedUy that t have determined through held inspections and +'•'. ' �" review of Municipal records that the above systems are In conformance wdh MDA HAA guidelines in effect on this date. sy A. on., Engineer's Printed Name JEFFREY A GARNESS�+q �— 9 , • •..tq ji37Ati Dato fo�r3/oS o°Protos�`d HAA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number (R". law) 'DOL M„OO,EO„O N I& YT aYxraNT -------------------- i ■ •�r• � M��•a IeYI ,00-00L 3,OO,e O,O S __ 8LlL-Q ROAD m 9 Y 0 T XD. LL Q P W O 10 b�sp 4 �j o,.Q 9 Y a 10-14-05;12:07 ■ SGS/CT&E ENVIRONMENTAL SERVICES a ;• .a . ',. Drinking Water Analysis Rleptirtfor Total Coliform Bacieria , READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLEcTINO SAMPLE , MUST BE COMPLETED BY WATER'SUPPLIER PUBUC WATER SYSTEM toe I PRIVATE _WATER SYSTEM Send ReeUtts w wM Mb.eG11eW fJe.CMw N.wwe •' tw. • 3 G i79 U33�s3�N(d FY •M. V "1. e.ey Yarw. , GY /� SNM Y SAMPLE COLLECTION; • n..r�w. rw••+r.Mrw�.e^w..wrern Dalet L.f� �0 'L�O� 907 561 5301 # 1/ 1 200 W. POTTER DRIVE ..; ANCHORAGE,ALAskA 9518 Tel: 907-562 2343 ; Fax 907-561.5301' 1056743 Send R". - 13s'a llnueM •• wew N•...e.eC.e.✓1'MMe I rM.011.w. Rr.Nvwrr _ .. • Fe�NW.r '. e.ey Yarw. , 7-7 SAMPLE TYPE vRoutine 0 Repeat Sample y13Tree bed Water Untreated Water (refer to lab no. 1 Q Special Purpose Trwaponed ' loc" er. Same as collector Other: TO BE COMPLETED BY LABORATORY Sample Receivin0: 'Date: GO•[O-�� Temp: Delivery Method: G Received or. Comments: Sempt40vV 30 hour aid: ❑ i RUSH SAMPLE ResuRa mey be ureseBNs 13411Phone#: For R e Lagdor,e Fax#: .............................................................................................................................................. FlacterfoloalralWator Analysis Record: '�NbAO MMO-MUG tP/N RESULTS: ANC F.SK AA ' EC Anelysh Bepan:. / p �%3,i• Total CeGlorrm !Oatelrlme: ' An:lyse , E COIL, . Sent Ondlent Analytical Method: MEMIDWERLTMItESULTTS: Phoned Q rakedO • D1root Count ,eolonleshOoml- 'DatelTinta; Membrane Filter VaMcetlut; Spee* Wm: MMO-MUG (P(A) T..e+ w •La, ' • {ece• aUl sfactory /�e.d.. { Et- ❑ Unsailsfactory Reported By: S•e �.. f'r Datamrne TM-TMNmerwer.aew. 04.p %.at.N. forma FW 0053 12M7103 tludeelnseOlvWK GmupOata\PUbldDOCUMENreORMStapprovod%CoIIForm121703.Ids 4-xu-ub;19:4b ; J GS Ref.# 1051811001 Tient Name Gamess Engineering Group, Ltd. tioject Name/# Vallhalla S/D Lot 4 Bk 3 Gent Sample m Vallhalla S/D Lot 4 Bk 3 latriz Drinking Water ;rui ee1e0ul All Datesfrimes are Alaska Standard Time Printed Date/Time 04/202005 8:02 Collected Date/time 04/072005 13:54 Recelved Date rime 04/072005 15:11 Technical Director Stephen C. Ede ample Remarks: EP300 - Sample rem outside of hold to confirm original concentration. Concentration confirms. Alloaabie Prep Analysis vameter Results PQL Units Method Container Limits Data Date [nit iters Department Nitrate -N 0.100 1.1 0.100 ierobioloav raboratory Total Coliform 0 mg/L EPA 300.0 B (o-10) 04/08105 CAM coV100mL SM209222B A (<-I) 04m7/o5 TIF Municipality of Anchorage Development Services Department Building Safety Division` On -Site Water & Wastewater Program 4700 South Bragaw St. s� P.O. Box 196650 Anchorage, AK 99519-6650 �10 e www.ci.anchorage.sk.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 05_141a_15� HAA# nsi)iA�� 1. GENERAL INFORMATION Expiration Date: S 11 Complete legal description VALHALLA SUBDIVISION: LOT 4. BLOCK 3. )♦ Individual On-site Location (site address or directions) 12231 SHILOH ROAD • ANCHORAGE. AK 99516 Current Property owners) Mailing address Lending agency Mailing address Real Estate Agent Mailing address SHAWN STEPHAN Dayphone_c/o AGENT c/o GAGE STEPHEN w/ PRUDENTAL JACK WHITE Day phone GABE STEPHAN w/ PRUDENTIAL JW Day phone 3801 CENTERPOINT DRIVE . ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 244-6423 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well )♦ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Weil ❑ 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 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 axed 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 (les 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. Engineers 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 8 Regulations. The reported results described the performance ofthe 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 benefil 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 JL Approved for 5 bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms, P - Phone 337-6179 Date 5 44%us Maintenance Agreements Supplemental Engineers Report Other By, A, r �Jr ,_ 0 Original Certificate Date: (Rw. 17)01) Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water d Wastewater Program 4700 South Bragaw St. P.O. Box 195650 Anchorage, AK 995196650 www.d.anchorage.sk.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: VALHALLA SUBDIVISION: LOT 4. BLOCK 3. Parcel ID:Lam=?Q-!moi A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N/A Date completed 5/15/1979 Sanitary seal (YIN) YES Total depth 170 ft. Cased to 170 ft. FROM WELL LOG Date of test 5/15/1979 Static water level 140 ft. Well production 10 — g -p.m -Web WATER SAMPLE RESULTS Coliform 0 colonies/100 ml. Arsenic: N/A mg./L. B. SEPTIC/HOLDING TANK DATA Nitrate 0.1 mg./L. Log (YIN) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 4/7/2005 77 ft. 5.7+ g.p.m. Other bacteria 0 oolonies/100 ml. Date of sample: 4/7/2005 Collected by: GEG. LtD. Tank Type/Material UNKNOWN Date installed 1979 Tank size 1250 gal. . Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 4/7/2005 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA Data installed "1979 Soil rating (g.p.d./R=ooJEEm) 185 System type TRENCH Length 32 ft. Width 3 ft. Gravel below pipe 11 ft. Total depth • 14 ft. Eft. absorption area 737 ft' Monitoring tube YES Depression over field NO Date of adequacy test 4/7/2005 Results (PasslFail) PASS For -3 Fluid depth in absorption field before test 0 in. Water added 101 1 gal. New depth 44 in. Elapsed Time: 120 min. Final fluid depth 27 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot '79' Absorption field on lot "90' Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water main N/A Water service line 10'+ Surface water 100'+ 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation t0'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkinglvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS WAIVER G. ENGINEER'S CERTIFICATION,. I certify that 1 have determined through field inspections and e'' / '+r review of Municipal records that the above systems are in P.1 . T conformance with MOA HAA guidelines in effect on this date. ............. Engineer's Printed Name JEFFREY A. GARNESS4f.� VOE-- .f f/ ` AT, Date ,7/3/y� 41Plorsss 1, HAA Fee $ '1 y,J�j' Date of Payment Receipt Number (Rev. 12101) Waiver Fee $ � \4'& Date of Payment C-) -q Receipt Number l� 4-20-06:12:33PM: FTI :907 6616301 • A— 2 CS Ref.# 1051811001 All Datesnimes are Alaska Standard Time Sent Name Gamess Engineering Group, Ltd. Printed Date/time 0420/2005 8:02 toject NameMl Vallhalla SID Lot 4 Bk 3 Collected Datefrime 04/072005 13:54 Gent Sample ID Vallhalla S/D Lot 4 Bk 3 Received Date/Time 04/072005 15:11 latrix Drinking Water Technical Director Stepben C. Ede snmie Remarks: EP300 - Sample renin outside of hold to confirm original concentration. Concentration confimss. Allowable Prep Analysis mncter Results PQL Units Method CoatainerID Limits Date Date Init aters Department Nitrate -N 0.100 U 0.100 icrobiololry taboratory Total Coliform 0 mg/L EPA 300.0 B (<-10) 04/08/05 CAM col/100mL SM209222B A (<-1) 04/07105 TLF 4-20-05:12:33GM: SosicilE ENVIRONMENTAL SERVICES Drinking WaterAhalysis Re DEAD =TV==" ON RE "M WX BEFORE • MUST BE COMPLETED BY WATER SUPPLIER ' O MM= WATER S snu ICI i Cd ORNATE WATER SYSTEM for Total Coliform. t3acterja . R111f. SAMPLE' . :901 5615301 a A- 3 200 W. POTTER DRNe; ANCHORAGE; ALASKA 99813 Tek 907-562-2343 F= 907.661-5301 SAMPLE COUECT10M:1'r •. ' a.... LTJ a a.r L—!61—,l.11��11. �a; Li m to tab Or ' Q Sartw as'caBetter • Od" BE COMPLETED BY LABORATORY Sample RiceivinfC Temp: OL --V6 DeWery tkmod: ReuMdBy: ^� Conn,nitt . i i�., it ,• -'l �v_ • • •'Qzoo*" rOObow"W'. 40•PAM SAMPLBW..'•j •�•' QMf1ovM,ianrr 4o�waahll .,P1Wfle:: •� 4'� � •• '•• Fox t 1_ • " x,• ... ..NNNM.N........•••••N.N.......NN.......N......NN...N.. N..NN........................ wNN.NNN.\N.... • •Becteriolo4leamterAnahnis R22201'... k;' • S.Rcto4oE¢ ' . EBIO'M16 Pey RE3tll73.'.. ... ,: _ .�(..• Fmc .AJN • ----------------- A,uyab B.aao: -H/7/ 5� ./l/�'_. •,TahiCetaae , • MEMBRAdE TEA 11ESILT'fi - •. •• • P" Antlyer+t Md,1ok . .. . Mmd Count ; etldlmnoaRL Da.RYnr Membrane FUter v.,ek&e�t MMiO-MUG (PIA) w�•- :� {so -Sadsfadory :Unsatisfactory . %� %• 7Rft.lwMwn.tMt.wt eported By YJ �l Datamme: -fir :r t I - -«6'::' w.aa....w. Fam 0 Fye DOM 12/17/03 • SAUPLE TYPE:., .. • . . .. •RRoutkl/ :.: >. •13 Turfed Water . ....� 0 Repeat Sample O tkriraated Wrtar (Wer to fib. no. ' t sp"l puipoR.... .. . 4. i i�., it ,• -'l �v_ • • •'Qzoo*" rOObow"W'. 40•PAM SAMPLBW..'•j •�•' QMf1ovM,ianrr 4o�waahll .,P1Wfle:: •� 4'� � •• '•• Fox t 1_ • " x,• ... ..NNNM.N........•••••N.N.......NN.......N......NN...N.. N..NN........................ wNN.NNN.\N.... • •Becteriolo4leamterAnahnis R22201'... k;' • S.Rcto4oE¢ ' . EBIO'M16 Pey RE3tll73.'.. ... ,: _ .�(..• Fmc .AJN • ----------------- A,uyab B.aao: -H/7/ 5� ./l/�'_. •,TahiCetaae , • MEMBRAdE TEA 11ESILT'fi - •. •• • P" Antlyer+t Md,1ok . .. . Mmd Count ; etldlmnoaRL Da.RYnr Membrane FUter v.,ek&e�t MMiO-MUG (PIA) w�•- :� {so -Sadsfadory :Unsatisfactory . %� %• 7Rft.lwMwn.tMt.wt eported By YJ �l Datamme: -fir :r t I - -«6'::' w.aa....w. Fam 0 Fye DOM 12/17/03 7 0.00 L M„00,1:0„0 N 10' Y LR •a•aMaMT ------------------- i •1N° `00 a • • _ 1 \ ° � Tl . :�_: IL : FI Q P W d \ \ s 100-00t 3„00,C0,0 S __ SHILOH ROAD m ° BJP• . :�_: IL : FI Q P W d 100 b'�'�•I •• .c GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS May 2, 2005 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: Waiver Request and Health Authority Approval for Valhalla Subdivision; Lot 4, Block 3. The existing 3 bedroom house is served by a private well and septic system. We request you grant a 79 feet separation distance waiver from the well to the septic tank on the referenced property; and a 90 feet separation distance waiver from the well to the drainfield on the referenced property. The following items are justification for the waivers: • The lot slopes downhill from the well to the septic tank and drainfield. Also the house is between the well and the septic system If the septic system was to overflow, it is not possible for the effluent to travel toward the well head. • The location of the septic system is in a very visible area so that if any effluent was to surface, it would be noticed and the problem corrected. The other path of contamination is subsurface migration of wastewater should the tank begin to leak. As can be seen on the attached well logs, the static water levels range from 21-140. The geological profile of the subject and surounding wells consists of clay, silt, and sandy soils that have served to inhibit the migration of untreated wastewater into the aquifer. Recent water sample results indicated nitrate levels to be 0.1 mg/L and coliform bacteria results to be undetected. Based upon the aforementioned facts, it appears that there is minimal risk associated with the 79 feet and 90 feet separation distance waivers. ase contact us at 337-6179. Thank you for your assistance. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179 0 Fax: (907) 338-3246' Website: gamessengineering.com LOT 2. BLOCK 1; _SHENANDOAH HILLS S/D _ I LOT 7. BLOCK 2; 1 I VALHALLA S/D I I � I I / I LOT 8, BLOCK 2; I I VALHALLA S/D I I C EPTIC \ 1 i AR� SE TI ' LOT 3, BLOCK 1; 1 SHENANDOAH HILLS S/D i . I I I I I I LOT 14, BLOCK 3; I VALHALLA S/D I I I I LOT 13, BLOCK 3; I VALHALLA S/D VALHALLA S/S/DCSE.,, I I Q ... I i Ip , `\ ( \ LOT 8 BLOCK 3; I VALHALLA S/O I LOT 7, BLOCK 3; I \\ i i VALHALLA S/D AREA Y LOT 3 BLOCK 3; I VALHALLA S/D I 1 I I EXISTING i LOT 12, BLACK 2; 3 LOT 1, BLOCK 3, 1 / LOT 3, BLOCK 3; I HOUSE / VALHALLA S/D I LOT S. BLOCK 3; /� I �•1 I I VALHALLA S/D I • S / `\ \ LOT 9, BLOCK 2; VALHALLA S/S/DCSE.,, I LOT 11, BLOCK 3; P AREnI 7 DWS Q ... I i Ip , `\ BLOCK OJ LOT 10, I VALHALLA S/DCSEm = AREA Y LOT 3 BLOCK 3; I VALHALLA S/D I 1 I • S / `\ \ 1\ PAR!TCQI ELA _ — I / LOT 2, BLOCK 3: I LOT 11, BLOCK 3; BLOCK 3; I / VALHALLA S/D I VALHALLA S/D `\ ARCS—EPEA \\ LLJ OfI LOT 3 BLOCK 3; I VALHALLA S/D I I / < LOT 10, BLOCK 3; V / I VALHALLA S/D LI QI LOT 12, BLACK 2; • S / `\ \ K LOT 11, BLOCK2; _ — I / LOT 2, BLOCK 3: I LOT 11, BLOCK 3; VALHALLA I / VALHALLA S/D I I VALHALLA S/O `\ ARCS—EPEA \\ LOT 12, BLACK 2; LOT 1, BLOCK 3, 1 1 LOT 12, BLOCK 3; VALHALLA S/D VALHALLA S/D I I VALHALLA S/D I I I E i GARNESS ENGINEERING GROUP, Ltd. 4 CONSULTANTS& GENERAL CONTRACTORS ......• •• •• ••••• ••••••.••• fN1 [ TI[Cl1 ENO. 9e 101 • MibMRK[. w tom? .FINS W71377-I.T • r" lb-uu PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •••• ••••••• •••••••••• SHAWN STEPHAN 244-6423 (AGENT) 1 OF 2 �Q '• If Y G rness:' LEGAL DESCRIPTION: DRAwN BY: OQ°yJ CE 7953 ,•' `Fo VALHALLA SUBDIVISION; LOT 4, BLOCK 3. C.J.G. �On�e ' �T�oS• ' CVA TYPE OF WORK: DATE: UQOOPr f —,,0 SITE PLAN FOR WAIVER PACKAGE 1 5/2/2005 (Rev. 0105) .y- O ' 100' WELL RA O J VALHALLA S/D; LOT S. BLOCK 3, �EXISTING 1250 GALLON SEPTIC TANK .01 � /I / \ I EX�IEL WL G WELL .z.,•_ -___.____._ _. po EZ GARNESS ENGINEERING GROUP, Ltd. p;?• �9A CONSULTANTS d GENERAL CONTRACTORS 3"1 C TOM IIO.D. !1R 101 • N4MK OL -W FlT .'l IIN7) t) %N • FAS (F07n)M-MO • g41L w�.,a. pwn PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • • • ......• ......••••• SHAWN STEPHAN 244-6423 (AGENT) 2 OF 2p If e rness.:j LECAL DESCRIPTION: DRAWN 8Y: OQO$. CE 7953 •' `FG VALHALLA SUBDIVISION; LOT 4. BLOCK 3. C.J.G. TYPE OF WORK: 0 dPF°(assT°�Oo� DATE: Q DETAIL FOR WAIVER REQUEST 5/2/2005 (ROv. 0105) Box 193021, $1'Ate lkoverl: A 90,302 n'IX INCH WATER WELL. DRILLED AND CASED OUT TO THE DEPTH OF170/I�;-' �_ DRILLED AT THE RATE OF -i 18.50 PER FOOT. �7/ ' Yr U PROPERTY OWNER Ak, Don Daht 344-5720-- �-�ry j� -- LOCATION OF WELL SITE Sa•——••-•-----• •.__ --.. DRILLER ^fl& n.ie Cla" o� RamE!u& D.t.Ll iin .EgtU. WELL LOG: 0----34' S•taucl and 4t yA acu t L Inde t. 34---95' Sd l ty.�a! �tavo,L wet wUh 30% a tw. 95--134' ldet cloy. 15% 4and* matur.L" Ra 94"" 134-169' IkAdpan. ._ __—____..----•------..�_��_. _ 769-170' Sand clean. Water Leann¢ 9-uw L wtth a p.tod rUam of 10 ropy w4a 30 AeA of. water. 4tand 4A CA44 9, 1/2 11044e Sub PUMP 4hou.ld be ln4talled lice {•aet o1(. 4 boat extm-oton.ad&A to.AMe 170 feet: Chatge: 828.00 Ao thaW At lde,U. Seal. COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF. S3173.00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE_ -17a1.15 -:!N :1979 n 4N WN Certified Well 4 - For.. Ae.--r Goode... .... .. .. .... .... . ♦ Location.... Milderness.Una ...... Date completed... /Pril 26, 1967 2 Depth of well 7/. el, Sim of casing. ....... 6. . ........ ... rjl t Distance to water:..... .... ... Distance to water while p=*!e,*-.:..,.* 110-.7cat . at rate .. 4 of ;.400 .. .. . .... 14 % Dcs-.riptl6ii'*i from to e:e Driller Bond & 0 WELL MILUNG UrAw Park 074CLUOY Road Spetatd. Alaska Wq ad%.Ue you to attach this tvrtificate In your deed jxrWy the above.9ve. and q=cct. it e:e Driller & 0 WELL MILUNG UrAw Park 074CLUOY Road Spetatd. Alaska Wq ad%.Ue you to attach this tvrtificate In your deed Well -i�L For ... .........���;t�i. at/� .......cU�'i: v.��L/., . .... ........ . Location ...... cl�s.e- ,::�........... Date completed......1.!r'...1,;./.%7................................................ Depth of well ... ..... /"�s .,����/.'........ ... .......... ................ ............. ... . ... Size of 631ng......�....�r��. t:�.. -..ti- . ... .. ......... ... Distance, to water...... .................................... .. Distance to waterwhile pumping.: �.',::.l i ..................at rate x ,�r�%• of ... :...ZA0..........................gallons per hour. Format on from to IA -kell i '' n.2_ Driller DELTA DRILLINO COMPANY mt 004 led a •NCMOW.0 g,•t.•µK jes01 -.4 .we ......................... For .......... Location .. . ...... I .......... .......... Date completed........ A I. .. .... ..... I...................................... . 07 Depth of well.. .. .................................................. Size of casing ..... T..: .......... ........................... ............. Distance• to water ........ Distance to water while ppi ...... . . ................ at rate ........ ... ................ long394*0 ur. _ 6.471 DILTA DAIA I to I.... W. JI 7 6.471 DILTA DAIA I 'P411 )ji4G' CD/V7AACTO)<j'tI�) `r iR��fR? r � brvnnit ; Cy,�r'r •.t; ti1►,� *: A'D 49 r c /v : .o . 'elk t .: ;D9i��•1�1t„cxD : AU�osr;.•19�'4�:: Ai ' '70 fT. '`•ri12Ff:`- tr ^!• .-i �..T". • .. :�:y.: 'tit•••:-..: cl VA •{.�• ; :;I•: �,�;: ... �. o-:• fry.; P-'Xir• t \Y it S,lNl1ACl'�,At/1YN,`r•'-�//•,. .�j•�G ,; a'! .�.. . •.. qtr..• :'1s dj't! .�r!a.�,•Yt:� r.lx rts�a .� r. �4`j'aiJ fC'rt-�%a�� tis s`=:� c• _ } '; r�.�l.i A•f<�it`(, i'�t%:fir :�ai:••'•. :. ,'t•. ;j:�17`! �:},\7 1 T " '!tiR r'� r•;} /•.1 'tn' t t M al`...'1` 'j q. RR j, •�! .d: ..' r .�.L41. ;ti r lsQ'1 it%+,�4r .� \ - .1�•r •�rJ/'�Cy�;�(.�•i;<,S t� rPa , ..., � •a lh� rel„}• •yam}v'�•ah at3i•<a:: •`,'•:wl�.:"., •!:+•'7i. ,fit .�. t� .'1!. tvT: `•...; a. v i ': �j�a`!i':•:1,t, Vit.:. 44 Rn IS Vz �.ff 1.:t�r1 :.a.jai 1�'•i: l •if tli'i.$ ll'j� r3y�. i1; `1.*o`i :•'/1'/...ty1'•I:i''"1t A''� :•':i��Jt�Y`' ,'i<: �4.'.:,t:}Lj$:\/il: ''��i1�i L' it S,lNl1ACl'�,At/1YN,`r•'-�//•,. .�j•�G ,; a'! .�.. . •.. qtr..• :'1s dj't! .�r!a.�,•Yt:� r.lx rts�a .� r. �4`j'aiJ fC'rt-�%a�� tis s`=:� c• _ } '; r�.�l.i A•f<�it`(, i'�t%:fir :�ai:••'•. :. ,'t•. ;j:�17`! �:},\7 1 T " '!tiR r'� r•;} /•.1 'tn' t t M al`...'1` 'j q. RR j, •�! .d: ..' r .�.L41. ;ti r lsQ'1 it%+,�4r .� \ - .1�•r •�rJ/'�Cy�;�(.�•i;<,S t� rPa , ..., � •a lh� rel„}• •yam}v'�•ah at3i•<a:: •`,'•:wl�.:"., •!:+•'7i. For ........ -�� .......-ell i„O ». ,.:.:r/...:...: �.... .............. Date completed.... lt» .�:..... ✓✓.,zolze , Depth ol,we......(;1.....: ! . ........................i............................. ll Size of . . ......... ...... Distance to water...,,, ..z ~- Distance to water while pumping.../,j:�i �, . .,,,,.., • ... ..at rate ...........................gallons per hour. Driller DELTA DRILLING COMPANY ON• wr t#4 a •aCHORAGI. AL.ia4 q{ui r Formation rom to Driller DELTA DRILLING COMPANY ON• wr t#4 a •aCHORAGI. AL.ia4 q{ui r Municipality of P.O. 1Aa 19fi6N) • Anchoage, Alaska !0519-6CM • Telephone (!M)7) 3%3-B:701 • ras (!M)7) 3%3.K1X) 47(X) Bmgaw S(recl • Anchorage, Alas)m !Y.R)7 xvI"Iunl.org Mayor Mark I3cgich Ilullding Safely DhOsion 5/11/2005 Gamess Engineering Group 3701 East Tudor Road, Suite 101 Anchorage, Alaska 99507 Subject: Waiver Request for Valhalla Subdivision, Block 3, Lot 4 Waiver Request #WR050025 Parcel ID #015-212-15 IiAA# IIA050186 Dear Mr. Gamess: Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the private well has been approved. The approved separation distance is 79.0 feet. In addition, your request for a waiver of the required 100 feet separation from the septic tank to the private well has been approved. The approved separation distance is 90 feet. This waiver approval applies to the existing absorption field and septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Julie Makela, P.E. Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Valhalla Subdivision, Block 3, Lot 4 Parcel ID: 015-212-15 Waiver for 79 feet from septic tank to well and 90 feet from absorption field to well Issued May 11, 2005 General 1. Total coliform, other bacteria, and nitrates were not detected for the water sample collected from the well on the subject lot. 2. The well on the subject property was installed in 1979 at a total depth of 170 feet. The static water level on April 7, 2005 was 77 feet. The well is cased to a depth of 170 feet. The well logs for surrounding properties Indicate that the wells In the area are completed In a confined aquifer. The confining layer appears to consist of approximately 74 feet of clay and hardpan (silt). 3. The wastewater disposal system on the subject property was Installed In approximately 1979. The construction materials and total depth of the septic tank Is unknown. The absoprtion field is a deep trench and is located 14 feet below existing grade. 4. Due to lot size and location of septic systems and water wells on surrounding properties, there appear to be limited area on the subject property to meet the current minimum separation requirements for a wastewater disposal system or water well. ADEC Criteria Points Water Table 7.3 Depth of well 170 feet Total depth of absorption field -14 feet 156 feet x=56/190+7.0 x=7.3 Soil Sorption 3.6 Soil descriptions from well log for subject property Gravel & silty clay 14 - 34 feet Silty, sandy gravel w/ Gay 34 - 95 feet Clay 95 -134 feet Hardpan (silt) 134 -169 feet Gravel 169 -170 feet (20/156 x 2.5) + (61/156 x 2.5) + (39/156 x 6.0) + (35/156 x 3.5) + (1/156 x 0.0) Permeability 1.9 Soil descriptions from well log for subject property Gravel & silty day 14 - 34 feet Silty, sandy gravel w/ clay 34 - 95 feet Clay 95 -134 feet Hardpan (silt) 134 -169 feet Gravel 169 -170 feet (20/156 x 1.0) + (61/156 x 1.0) + (39/156 x 3.0) + (35/156 x 3.0) + (1/156 x 0.0) Water Table Gradient 4.5 Subject well is upgradient of wastewater disposal system. Assume 5% slope Horizontal Seoaration 2.2 79 feet between septic tank and well x=4/25+2 x=2.2 Total Points 19.5 As per ADEC waiver guidelines a point value of 19.5 is almost sure to be free of any form of contamination from household sewage. Municipality of Anchorage Development Services Department • Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchomgc.ak.us (907)343.7904 Waiver Review Worksheet WR#: WR050025 PID#:015-212-15 Date Received: 51912005 HA#: HA050186 Permit#: _ Legal Description: Valhalla Subdivision, Block 3. Lot 4 Engineer. Garness Engineering Group 3ZIl�ill�l•1'IT?S1F�It , Applicant: Shawn Stephan Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: —7 ") - I1? 1.9 y.5 nQ . r) Total: t9 •4:� ..................................................................... ..°°°°ess@ Waiver Is Granted: _I Z� Waiver is not Granted. List Conditions or Reasons for above: Date: By:Qt.. 6. , M o 0 C_ �iName of Reviewer ..................................4.3 e......ess............................. Rec#: 67362 Amount $11150 Date Paid:_