HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 2 LT 20 Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: t c�
I �S I I � PID Number: 015-322-38
Dwelling: ❑■ Single Family (SF) ❑ Duplex(D) [' Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade
Name:
Jerry L. & Steve C. Opsahl ABSORPTION FIELD
Address ❑ Deep Trench ❑� Shallow Trench ❑ Bed ❑ Mound
6260 West Tree Dr. Anchorage, AK 99507 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
907-441-4609 3 1.2 GPD/SF 11.0 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade 'Gravel depth beneath pipe
Subdivision Block Lot 7.0 Ft.4.0 Ft.
Valli Vue Estates #2 2 20 Fill added above original grade Gravel length
Township Range Section 0.4 Ft. 39.0 Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES 5.0 Ft. Ft.
To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches
From Tank Field Tank Line 390 Ft2 1 Ft.
Well N/A N/A N/A N/A >25' TANK ❑ Septic 0 S.T.E.P. 0 Holding ❑Other
Manufacturer 'Capacity
Surface water >100' >100' N/A N/A Gal.
Material Number of compartments
Lot Line >5' 6.5' N/A N/A
NA
Foundation >10' >10' N/A N/A LIFT STATION
Manufacturer Capacity
Curtain Drain None Noted Gal.
Pump on level at Pump off level at High water alarm at
Remarks
_ in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank D3034Tank to D3034
Installer drainfield
A+ Home Services Drainfield D3034 CO/MT D3034
Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft
Inspection 51 5/23/18 2nd 5/23/18 Location and description
dates3id 4th Top of NW sono tube under back deck.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL —tt\\\\
�`C 140
Conditional Approval: Date rAgiQ: •. ,......._•4t
0*: 49TH f' •.*fi• r
/� • Benjamin Schiller
f ej-lre-412--- &
OOk fie •. C 1292 .•.`%�
Approve•/ ��� — Date 5—'30 -a 14PROr ESSIONP;
Inspection Report_9-1-12.doc
VALLI VUE ESTATES #2 B2 L20
S' PERMIT # OSP181103 PID # 015-322-38
LOT 21
•
I
• "'i TH#1 "i
• C'3•MT3
39'LONG X 5'WIDE X 4' I MT2 CO4 1_01E1 20 „/
EFFECTIVE DEPTH Cp MT €6 a
EXISTING 35'L X 3'W X 6' I FDV'rn I W
EFF.DEPTH TRENCH C�■O ®L-••••••••
' ' W
_J
SV ti:.:.::.::::::::::::::
BULL RUN DIVERTER VALVE 3 BORN HOME I-
�� 'III H
CC NTR DL VALVE TO FC 9 _----
Cl)ORIGNAI�SAEPPPTCD COT i
ORIGINAL TANK FILLED WITH I
PEA GRAVEL,AND PIPES TO
10'UTILITY EASEMENT
ORIGINAL SEPTIC CUT BELOW
I
GRADE AND CAPPED OFF
' 1
- WATER SERVICE
J• - - (LOCATION NOT EXACT)
LOT 19
A B C
2C0 --- 21.9 39.4
FDV --- 21.7 39.9
MT1 --- 24.2 51.2
MT2 82.3 _ --- 69.2
CO3 83.2 --- 71.6
MT3 • 50.2 29.7 ' ---
004 48.2 27.4 ---
GE
ENGINEERING
NOTE:
,`......�xx v NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND
'�.-7- OF.. ,q��i PROPOSED SEPTIC SYSTEM CO CLEANOUT
tb. .9 �0 2C0-DOUBLE CLEANOUT
• ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS FCO-FOUNDATION CLEANOUT
* •
TH /\ ••* /, PROPERTY ARE SHOWN.NO CONFLICTS WITH WELLS OR SEPTIC FSC-FLOW SPLITTEROVALVE
.. ..• SYSTEMS.
Benjamin Schiller / PTH-PANNONE TEST HOLE
r+9F•• CE 12592 `,% 0 50 100
f /rI••.,�May25.mle •.•'��� = — ME NM FEET SLOPES>25% MT-MONITORING TUBE
il00.;....1o0 :, =SLOPES>46% SV-SEPTIC VENT
����\"`� 1'—50 TH-TEST HOLE
VALLI VUE ESTATES #2 BLOCK 2 LOT 20
PERMIT # OSP181103 PID # 015-322-38
/— 97.4 FINISH GRADE
Ov / 97.0 ORIGINAL GRADE Ov
_ /.
90 90'0
DRAINFIELD ROCK
86.0 86.0 -----• �
39' -
..,A— 79.0
NO GROUNDWATER 5/22/18
Q
1-
-.,-N_NNA
o' .&4,
"eco.
4i� �9*ill
Benja• Schiller : P
PROFILE AS-BUILT i�PF•. CE 12592 ••�,�--
oil•.. May 15.59 ...• (QA(NO SCALE) ,II F°PRO....AnN�...=illifitGE
n'4iH[[RiHG _
,573 — 5? ISO
MUNICIPALITY OF ANCHORAGE »enc
�., On-Site Water&Wastewater Program \o
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
http://www.muni.org/onsite
bi
_. Ice pa
4 ,
NCNON P4
On-Site Water and/or Wastewater System Permit
Permit Number: OSP 1 S I 1 03 Effective Date: /77(1 c2c 2,9 IS
Work Type: S42.021 c 0.�� Expiration Date: rvlday Z 2 ,201 q
Tax Code Number: (/ '
Number: ..., 3a� - 3g
Site Legal Address: \Ic , ue �S-��4eS a Qlx� Lo-4 0
Site Mailing Address: ( ,)(o� SPS-} Tree 1)rVe1 PmO.,orc3e, .Pt 9 5 07
Owner: OPSAHL STEVE C & JERRI L Lot Size in Sq Ft: c0, J y
Design Engineer: FORGE ENGINEERING Total Bedrooms: 3
This permit is for the construction of:
u Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: If it is determined that the tank needs to be replaced, submit change order for review and
approval.
Received By: �/ Date: 5/tc 1
fyr-
Issued By: it- ,(ice 6)t,
p Date: 5,11
R ► HI
MUNICIPAL! OF ANCI-rOU6" 1RAGE , I
.
Community Development Department Phone: •'." �, •14 70 7,
Development Services Division Fax: . i -3 // • 1 /
On-Site Water & Wastewater Program a MAY
21 2018
ON-SITE SEWER/WELL PERMIT APPLICATION Zl ,,�(►
Z'p►' �ti
Parcel I.D. 015-322-38 �� 6 8 L 9 5
Property owner(s) Steve and Jerri Opsahl Day phone 441-4609
Mailing address 6260 West Tree Drive Anchorage, AK 99507
Site address Same
Legal description (Sub'd., Block & Lot) Valli Vue Estates #2, Block 2, Lot 20
Legal description (Township, Range & Section)
Lot Size 20,114 Sq. Ft. Number of Bedrooms Three (3)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field H Initial I I Single Family (SF)
(w/wo ADU)
Septic Tank ❑ Upgrade Ix
Duplex (D)
Holding Tank Renewal I IMultiple Dwellings
Privy n (SF and/or D)
Private Well I I
Water Storage n
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 4 q 0 ,40 Waiver Fees:
Date of Payment: 5 111110 Date of Payment:
Receipt Number: O 3(1113 Receipt Number:
Permit No. OSP Og N I O3 Waiver No.
Permit App_9-1-12.doc
.r•
GE
E N GIN EER I N G
PO BOX 240773
ANCHORAGE,AK 99524
522-7773 677-7766(FAX)
May 19, 2018
Municipality of Anchorage
Development Services Dept- On-Site Water&Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Valli Vue Estates #2, Block 2, Lot 20—6260 West Tree Drive
Septic Trench Design and Permit Application
Dear On-Site Services Engineer:
The septic absorption system on the above lot has failed, so we are submitting this permit
application for the construction of a new absorption trench. The existing septic tank was placed
in 2003. The integrity of the tank will be verified at the time of construction. The attached site
plan identifies the location of the home, water service line, existing septic location and the
proposed absorption trench. No conflicts exist between this proposed system and any other well,
water service or septic system, whether on this lot or adjacent lots.
Due to the depth of the receiving soils and the condition of the material above it, we were unable
to perform a percolation test. To determine the percolation rate, a visual assessment was made
and the test hole data from the four surrounding lots were used. All four lots had similar test
holes to the subject lot and identical percolation rates. The percolation results for those properties
have been included with this submittal.
The ground surface on the lot is virtually flat at the location proposed for the absorption trench.
There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate
site. Drainage arrows are shown on the site plan showing the grade and direction of flow. Storm
water drainage will not impact this septic system.
The new trench will be constructed parallel to the slope as much as possible. It will be a
minimum of 100' from all wells and surface water, and more than 5' away from the septic tank
and more than 10' from any water services in the area. We will install a flow diverter valve to
allow the existing trench to recover and be used as an alternate site.
Please refer to the attached test hole logs, soils lab analysis, plan and profile pages for the septic
design. If this design is followed, there will be no adverse impacts to adjacent properties.
Sincerely,
��P�E pF A`�S4I
•:vel
Michael E. Anderson, PE *. 49 TH 1' •*'d
. ... ... ......
94
Michael��,Micha 4 E.Anderson
7#
c�TF•, 5/19/18 ,•'�C�,�
1,iliF�PROFESS\ONp'
VALLI VUE ESTATES #2 B2 L20 - 6260 WEST TREE DR
LOT 21
j•
•• _ ^i_TH#1 _ 9
• I ZD 710'
38'LONG X 5'WIDE X 4' /• Cd) NAT iCo LOT 20ce
I
EFFECTIVE DEPTH-'. I e PTH
EXISTING 35'LX2'WX8' • ' :.I –• G* _m.--
W
EFF.DEPTH TRENCH '•:::: :::::::::::::::..:.:.... w
M 3-BDRM HOME :::::::: :: :i;;:::: :: CC
VERIFY INTEGRITY OF � ............. I H
EXISTING SEPTIC TANK „�
CONTROL VA VE TO SWITCH i * W
E EVEN SYSTEMS '- _�
DECOMMISSION EXISTING SEPTIC 1
10'UTILITY EASEMENT SYSTEM IN ACCORDANCE WITH
MUNICIPAL CODE(FILL TANK WITH
ACCEPTABLE MEDIUM)
1
--------r/VATER SERVICE
(LOCATION NOT EXACT)
LOT 19
illiit6E
ENGINEERING
NOTE:
``���\\\\� NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND
.t'P Akil<i PROPOSED SEPTIC SYSTEM
r Q.,.• l CO-CLEANOUT
,Z6.••
* 49TM j\ If? ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS 2C0 DOUBLE CLEANOUT
J�•� ••%' PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC FCO FOUNDATION CLEANOUT
r�:54 fi—L',• •••/ SYSTEMS. PTHFS-F POWPANSPLITTER
TEST VALHOLVE
Michael E.Anderson : Avi
9+�F.• -40,1-E '��i 0 50 100MI
%�,,,,,••• •"(7-� q••*%it ME = = = FEET
SLOPES>25% MT MONITORING TUBE
I`lF0PROFESSIO' N_ MI SLOPES>46% SV SEPTIC VENT
\\��\ _,`� 1 -50 TH-TEST HOLE
VALLI VUE EST. #2, BLOCK 2, LOT 20
DESIGN FACTORS: SYSTEM REQUIREMENTS:
450 GPD PEAK FLOW 5' WIDE DEEP TRENCH SYSTEM
PERK RATE: 1-5 MIN/IN VERIFY EXISTING SEPTIC TANK
APPLICATION RATE: 1.2 GPD/SF
450 GPD/ 1.2 GPD/SF / 5' WIDE * .5 RED. FACTOR = 37.5 LF TRENCH REQUIRED (38 LF SPECIFIED)
BOTTOM OF TRENCH: 11' BELOW GRADE
FLOW LINE ELEVATION: 7' BELOW GRADE
TOP OF TRENCH: .5' ABOVE GRADE
6"
- —III—III—III-III-III- -
' I I_I-I 11=1 I I-III-I 11=1 I I
1=1 11=1 11=1 I I-III-III-I
III111111111 II I11111111111111111
III—I 11-111—I 1 I-1 I I-1 I I
1�1111111111111111111111111111111
1-1 11-11.=111-111=1 I 1=1
III-III-III-I I 1-III-I I I
111111111111111111�11111111111111
1-111=111=111-111=1 I 1=1
6' 6" III-III-111-1I1=1I1=1I I
11111 EIIIIIIIIIIIIIIIIIIIIIIIIII
i=i I 1=1 I -1 I I—III-1 11=1
111-111-1 11=L-1 I I-I I I
-III-I I 1-III-III-I I 1=1
I I 1=1 I I-III-III-I 11=1 I I I
IIIIIIIIIIIIIIII111111111�IIIIfI
11111111111111111111�11111111111111
1=1 11=1 11=1 11=1 11=1 11=1
III-I 11=1 I I-III-III-I I I
1=1 1 19 1 1=1 1 19 1 1-1 1 1-1
:
''''•' `•''•''''=''•" =• " 4" PERFORATED PVC (HOLES DOWN)
•:�:•:• ::•:....;9:•:•:•;9• ::: DRAINFIELD ROCK
;9999:• ::;�:• ;!:.::::;::.;•;•::,
9;9 9• ;9;•;9• ;:: ::;9;9;?;•;9• ;9.
:.::;::9:9::::::;9.•;:;•9999..,
9:.r9:9:9;9;•;9;::•:9999999;9,
5
*1°G-EIwEl NTNG
TYPICAL 5' WIDE TRENCH SECTION
._ ACq� 1
(NO SCALE) .�P • 4 !f•91'I
NOTES: ...... ...49 TH /
1. GRADE AREA OVER TRENCH TO DRAIN AWAY "'�/P 1, 4
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' / Michael E.Anderson :•
WITH 2" OF INSULATION tl`,<6 •T� _483,1-E ,
3. THAN PREVIOUSLY CHECK DATER AT TIME OBSER ED COF ALL ENGINEER TION. IF LEVEL IMMEDIATELY IS HIGHER �>Il`\\\\```iti
MUNICIPALITY OF ANCHORAGEpr.4 .9ki
DEVELOPMENT SERVICES DEPARTMENT 70°.. `4 ..4-314
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 0*.:49L4 *��
SOILS LOG AND PERCOLATION TEST y .. n.
. Michael E.Anderson :
LEGAL DESCRIPTION: VALLI VUE ESTATES #2 B2 L20 it ;pPROfESS10N
PERFORMED FOR: STEVE OPSAHL
Professional Engineers Stamp:
DATE: 5/15/18 PROJECT No.:
PARCEL ID#: 015-322-38 TECHNICIAN: J. MILLETTE
•
TEST HOLE 1
(feet)
1' ORGANICS SLOPE SITE PLAN
1
2
4 't_ SOFT SILTY CLAY
5 =''"' �� '�; SEE SITE PLAN k
6
7 v.:irl
8
9 ,.
WAS GROUND WATER ENCOUNTERED? NO
1 0 IF YES a WHAT DEPTH? -
1 I • DEPTH OF WATER AFTER MONITORING: NONE' DATE OF MONITORING: 5/20/18
12 •j
DATE READING GROSS TIME NET TIME WATER NET DROP
13 - SAND (MINUTES) (MINUTES) (INCHES)
SW (INCHES)
14 TEST HOLE PRESOAKED PRIOR TO TESTING:
15
16
17
18
19
20
PERCOLATION RATE: (MIN/INCH) PERC. HOLE DIA. (INCHES)
TEST RUN BETWEEN: FT. and FT.
COMMENTS:
JCG
r V.CJ1 Inc
. A<t/4A/,[''g
ORDERED BY: STEVE OPSAHL
250 H Street I LEGAL DESCRIPTION:
Anchorage, Alaska 99501 LOT 20, BLOCK 2,
VALLI VUE ESTATES UNIT NO. 2
Survey Department
Phone 562-5291
Mainline
Phone 243-8985
AECC 668
9N
W
W
W
H
I—
U)
W
30 0�* : 4 9TH
p.. ........ .. ...:....DD
� � D
a AAASTEVEN CLLHN °oQ
LS -12 34 �Q
°fessiono\
NOTE:
THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN
WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH.
ADDRESS: 6260 WEST TREE DRIVE PARCEL #: 015-322-38-000
AS -BUILT SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF
THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE
IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO
LEGEND: ENCROACHMENTS EXIST OTHER THAN NOTED.
DRAWN DATE:
5/11/2018
WORK ORDER: 18038
Asphalt
DRAWN BY:
AP
PLAT: 77-296
CLEANOUT #CO -O
!EXCLUSIONARY
`Concrete .
NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE
WATER VALVEi
EXISTENCE OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY
CHECKED BY:
SC
GRID: SW2538
ng4tM
TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO
FENCE -X-X-
CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR
SCALE:
1" = 30'
FB/PG: 808/69 REF: 96L96A
Wood Deck
ESTABLISHING PROPERTY LINES, OR FOR PLOT -PLAN PURPOSES.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME ~ PHONE EW
I el~ ~ , AbsorPtion area O Owolli~ r ' PERMIT NO.
~ Monufact~rer~ Mat~ ~o. o' ~rt~on,s
~ ~ LIq.ia~c~ i~allons IF ,OMEMADE: Inside ,eng~ Widt~ ' Liquid Oe~
No. of lines Length o' eWi~ Total length ~n~ Trench widt[~ ~ DistancW~X(ne/~ ~ 0
~-- To ~of~)~tile finish 3 ~ches Total effecttve ~rea
~ ~ to grae I Material beneath tile
PIPEMATERIALs"OTHER~~
72-013 (F~ 3~78)
F'ERHIT NO.
BPPLICBNT
LOCFITION
I
DEF'RRTMENT ¢~, ~ERLTH RND EN","ZRONMENTRL ~OTEC:T]CIN ''DO )/~/'¢/
o.-,~ ..' :' , FtNCHORAGE., AK. 5~2 .i1 ~/~ ~,I
BRUCE C. PFRU 5700 LRKE OTIS PKHY ~28B UNK
HEST TREE
LOT 2~4 BLK '-' VRLLI VUE SUB LOT '~" ~ ~- ''
- ~ z,I~E 28t!4 z,~:41_IRRE FEET
TYPE OF' SOIL RBSORPTION SYSTEM IS: TRENCH
MAXIMUM NLIMBER OF BEDROOMS
SOIL RBTING
THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS:
[:.E F'T~-~= ~C2 LEi'4~] TI4= 4-JL r-]RF4~¢'EE- C'EF'TH== ~
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF FI TRENCH OR PIT IS THE DISTRNCE 8ETHEEN THE SURFBCE OF THE
GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THERE IS NO SET HIDTH FOR TRENCHES.
THE GRFIVEL DEPTH IS THE MINIMUM DEPTH OF' GRRVEL BETWEEN THE OUTFRLL PIPE
FIND THE BOTTOM OF THE EXCFIVFITION (IN FEET).
PERMIT FIPPLICRNT HFIS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTFILLRTION INSPECTIONS OF RNY HELLS RDJFICENT TO THIS PROPERTV BND THE
NUMBER OF RESIDENCES THFIT THE WELL WILL SERVE.
-rp~o <2> z ~-~SPEC:TIEi~-~S R~:E RE(~U~RE[)
BBCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION FIND BPPROVRL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTFINCE BETWEEN B HELL RND FINY ON-SITE SEWRGE DISPOSRL SYS'rEM IS
&OE~ FEET FOR B PRIVRTE HELL OR J~50 TO 2FsZ~ FEET FROM R PUBLIC HELL DEPENDING
UPON THE TYPE OF PUBI_IC HELL
MINIMUM DISTRNCE FROM R PRIVRTE HELL TO R PRIVFITE SEWER LINE IS 25 FEET FIN[)
TO FI COMMUNITV SEHER LINE IS 75 FEET.
OTHER REQUIREMENTS MRV BPPLV. SPECIFICR'TIONS BND CONSTRUCTION DIRGRRMS RRE
RVRILBBLE TO INSURE PROPER INSTFILLRTION.
F'ER[~fi Z ]- E~--:F' Z REL--~i., [:,EC:E~E:EF-: --~=: :]L.. 1.:9:S:1.
I CERTIFV THRT
i: I FIN FRMILIRR WITH THE REI;!UIREMENTS FOR ON-SITE SEHERS AND HELLS RS SET
FORTH BY THE MUNICIPRLITY OF FINCHORFIGE.
2: I HILL INSTFILL THE SYSTEM IN RCCORDFINCE WITH ]'HE CODES.
3~: I UNDERSTRND THBT THE ON-SITE SEHER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~: BEDROOMS,
RFPLICFINT BRUCE C. F%RU
I =,~ JE[. B -
PERMIT NO.
FIF'F'L I CANT
LOCAT I ON
LEGAL
I
DEPARTMENT OF HEALTH AND ENvlFI]NMENTRL F'r, OTEC:TION
825 "L." ':';TREET., ANCHORAGE.. AK. 99501
264-4720
~-~-~--.~. · TE SEb~ER ~'E~.'M I T
JOHN IdOTTSINGER
L20 B2 VALLI VUE ESTATES
6 ._,~:.'.'.4 ALRMOSA
LOT SIZE
24--'.':. ":' '="- ~'
~'~,_,L~ =.
26114 SQ_IRRE FEET
TYPE OF _.OIL. RB=,ORE, TION L=,.C_,TEfl I~...~. TRENuH
MRXtfdUN NLIMBER OF BEDROOMS =~//4¢'. ~'-~ SOIL RFITING
(
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
[:.EF'TI--~= 12 LE~']¢~TH-~- ~ ORR"-,."EL L"":..EF"TH= 7
THE LENGTH DIMENSION I-. THE LENGTt N FEET) OF THE TRENCH LR DRRINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE E).~CRVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
TFIE GRAYEL DEF'TH IS THE MINIMUM DEF'TH OF GRAVEL BETWEEN THE n~FRLL PIPE
AND THE BOTTOM OF THE EXCA',/RTION (IN FEET:).
RE,;!IJ I RED, SEPT I C: TRF~N; S I ZE=
PERMIT APPLICANT HAS THE RESPONSIBILITY tO INFORM THIS DEF'RRTMENT DURING THE
r~._rr.,r.',~' AND THE
IN_-TALLRTIuN IN_,FEuTION=, OF ANY WELLS ADJACENT TO THIS .... n'''''-'-''~'''
NUfflBER 6,iF RE~IDEN_.E_ THAT THE WELL WILL =,ER,,,'E.
E, MC. LFILLINu OF RNY SYSTEM WITHOLIT FINRL IN=,PEL. TIuN AND RPPROVRL B'T' THIS
DEF'RRTMENT WILL BE SUBJECT TO PROSECLTION.
MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
$00 FEET FOR R PRIVATE NELB OR
±50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PEF,,:I'.I I T' E.--.P I: RES [~-.EC:E~-IBER --~-,:1.. 1_ .- 9
I C:ERTIFY THAT
1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SE]'
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTFIL. L THE SYSTEM IN F!CCORDRNCE WITH THE CODES.
]:: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE tS REMODELED TO INCLL~ MORE THR? 4 BEDROOMS.
(
I ~,'~1 lED E,¢ ['~TE ~ ..... Y~q '~'
F'ERMIT NO.
.=-'. ':',~DEI,:'RRTME(,FI" 01':' HERLTI-I RN[:, ENVIRONF1E(',I-I"Ffi.. PROTECTION
~'¢ 825 'L'" STREET, FINCHOI'r,'.RGE., BK. ':TqB50::t.
264-4720
( 'P;3077::I. )
RPF'I-_ Z CFIN-('
1...0 Cl-4 T .T ON
JERR'.r' HFIF~'.D I N
I-,I-E'S;T 'TREE DR
L20 82 ',?RL. LI ',,,'LIE EST ¢~2
S)[(24 HI,:IRTZEL_L. RD
LOT SIZE
]:44
2::SJ::t.:;l..4 ~SI:;!URI,;?.E F:'EEE"F
'l'"'r'Pl-E OF SOIl.. RBSORBTION S:;'~-'S'TEM IS: TRE(qCH
MFIh:IP'ILIH F,IL.IF(BE:I:4: OF' ErEDROOMS = 4
SO]:L I,~:I,:YI,'ING ,::~;(;:! FT,'"E~R)=
'/'HE I:~:EQUIREI,) SIZE 0l-:' TI-'IE SOIl.. RBE:iC)RI.:'TICR',! S;'-r'S-FEH IS:
-I"HE L. ENGTH [:,IHENSION I'.:5 THE LENGTH (IN FEET) O1,::' THE Tl-:?.(EIqCl'-t C)R DRRINFIELD.
THE DEPTH O1':' l-:l TRENCH OR I,:'IT Z~; THE D]:STFINCE ['::ETI.,]EEN THE SUF?.FFIC:E OF THE
EiROLIND R(,ID ]"PIE: E*,OTTOi"1 OF: THE EXCFIVI,:WION (ZI'4 FEET).
THERE ZS NO S;ET 1.4IDl"I.'.I FOR TI:.':'.ENCNES'1.
'TI--tE C~Fd::IVEL DEPTN IS THE FIINZMLII'"I DEF'"r(4 O1,:' GRlaYEL E:ETI-,.IEEN THE OLITFFIL.L PIPE
[,:lNg, 'T'HI,.E E',OTTOH O1,:' THE E',:.::C:FIYF:ITZON (IN FEET).
I-:'EI:;?.H I T RPPL I CRNT HRS THE RESF'ONS IB I L.I Th-' -FID ! NFORM TI"I Z S DEF'RRTHEN'I" DUI:;..'I NG THE
I N~S'TI,rJLLRT I ON INSPECT I ON:.::-: OF RN"r' NELLS RDJRC:ENT TO TH i S I':>ROPEI.;~'.T"r' I'ZlNE:' THE
NUHBER OF: R(:~SI[:,EiI',tCE:S 'rl.4Ft-I' ]"HE I.qEL. L 1.4:[LL
i'dI(.,IIMUF'I I}IS:'['(:INCE IE~ETI4EEI'4 R NELL I,;:IND RN"r' C)N""SITE :SEP.II-:IGE DI:E;F:'OSFIL ':'?'r%"FEM IS
::LOE~ I,ZEET FOR R PRI'v'RTE t4EI.L.~ OR
J..50 TO 2~3EI l-ZEl-ET FROM F'I pLIBLIC P.IELL [.',EPENDING UPON THE 'I""r'PE (:IF F'UBLIC !.,.IELL.
OTHER REIS!UIREMENTS MFI'¢ RPPLh". SPECIF[ClaT!ONS F:I(',I[) C:O(',ISTRUCTION [:, ;[ RGRFIMS RRE
F:l'v'l,:l I L. RBL. E TO INSURE PF4'.OI,:'EI,;?. I NS]'F:ILLFTF I Cllq.
I CEF?.TIF¥ TI-fi:IT
:1_: I RM I-'-'I,:IMIL. IFIR I,.II'FH THE RE6!UtREMENTS FOR ON-:BITE SEI4ERS RN[:, I.,.IELL'_:!:; AS
FOI,RTH B"r' THE HUN I C: I PI,:IL.. I'i."¢ OF
2: ]; 14ILL IN:i~,TFfl. J.. THE: :F:;'T"_'STEM IN FtCCORDFIF,IC:E 1.4I]"H TPIE CODES.
:Z: I U(.,I[:,EI,.-::STF:IF,ID THI,:IT THE O(-4--.SITIE :SEklER S'-r'STEM MF('¢ Iq'.E-3]:iUIRE; E(.q...Fq:RC~EP1E:N-r IF'
RESII}ENCE I5; F?.EMO[)ELEI} TO ZNCLI_J[:,E MORE THFIN 4
E; :( GNE[:,:
:( E;';',:; U ['~: [) [~:"r' ........ :
I' ,KC -r I:::·
F'ERMII' NO.
I
[:,EF'FIRTMEN]:! 'HERL"FH FIND EN',,,'IRONHENTFII.' !OTECTION
,. 25:L6 E. I'U[)CII'~: R[:,.., RNmZ:HORFIGE, FIK. b,~sdilEf7
C~ ~"-~ ~ '.'ZEE; :[ 'T El YS~; E~ ~4 ~E E,;: F" EZ F~: ~',,-~ :E -E"
-~FF I_I _.Hiq F
L. OC:FIT I ON
L.E:Gf:IL
~'~'=' ST
...~.._, N FIFq" :1%±
Li3"r .:, ]. ~E
2Ct1.:1,4 E;QURRE FEE'T
T'¢F'E OF :,LIE -IE,...,_R.E, fZ_I',I .:,~_-,TEII l:...~: FFEN.H
I','IFI;,,;IMUM f~I..IflE. E..F.. OF EEEI._OfL = 4
_--' -'- ~'~' ,:: E;C! :].9;2
,_IL NHTINa FT/E:R::
THE: RE:'FORF'TIZN =,T._,f'EII I._.
;:F¢..."E:L. L...i-.ZF t H .... ,..-
'THE LENGTH DIMENSION IS THE LEblGTH <I~:
THE" DEPTH OF R TRENCH OR'. PIT IS THEE
GROUND FIND THE BOT]"OM OF THE E,'.v, cFI',,,'F
THERE tS NO SET WIDTH FOR TREENCFIEf5.
THE GRR',,,'EL DEPTH IS THE MINIMLIM DEF
RNI:::, 'THE BOTTOM OF THE E;qCFtVRTION
OF ]'HE TRENCH -re [:,RF~II'-,IFIELE:,.
E:ETb. IEEN THE: .:l.j~.f-I...E OF THE
FEE-F).
El]HER Fi L.L.H ..... I -F.' ]:I I',LF
E, EI'!JEEN THE OIJ"I"FFtLI_ PIF'E
U_,ED L. ENGTH IS
'-- ' '"
'T Bdl C* ,:: ;ZL" ]:, %
ERZKFIL. LING OF RN'¢ :r: FElt THOUT
DEPFIRTMENT P.IILL 8E S_EffEST
fNFIL INSPECTICIN FIND FIFFE_ .-IL THIS
MINII"IUf'I B, ISTI::INCE BETWEEN R 14ELL FIND RN'~' ON-.SSI'I"E SEP~RGE DI:BF'OSRL_
:1.¢8 FEET FOR R PRiVRTE WELL. OR 2E~E~ FEET FOR R PUBLIC [4ELL.
SPECIFICIqTIONS RND CONSTRUCTION [)IRGRRMS RRE RVRIL. RBLE ]"0 INLSURE F'ROPER
I NSTRLLRT I CmN.
F> E:£ F~: ~"1 Z "IF "-.-' R L_ Z £:, ICC- rj [~: El:, f-.B [E: %-" EZ F:~ IF':: F: F-'". C, ["-"~ % :55 :F$ E_.6 ES:
I CER'I"tF'¢ TFIR'I"
±: I FIH FRMtLIRR WITH THE REQUIREMEN]"5 FOR ON-SITE SEWERS FIN[::, WELLS FIS SET
FOR-FH B'-r' THE I',tUNICIF'RLIT'¢ OF RNCHORRGE.
2: I WILL IN~TR[.L THE S'¢STEM IN RCCORDRNCE NI-FH THE CODES.
2: I UNDERE;TRI'.~[:i "FHRT THE ON-E;ITE SEN[ER ?¢STErl I',iR'¢ REQUIRE ENLRRGE:MENT IF THE
RES i [:,ENCE I E; REMCE:,ELE[:, TiE I ~I~I..J[:,E MCiRE THFff.,I 4 BEDRO01'45.
~PL ZCRNT JuHN H(]TE;Z i.4GER-
MUNICIPALITY OF ANCHORAGE
Department of Health and Environmental Protection
SOILS LOG
PERCOLATION TEST
Performed for John Motsinger ~ Dat~ ~erform~ 6/1/76-6/2/76
Legal Description Lot 20, Block 2, Valley View Estanes Subdivision
6
8
l0
~6
(See a~ached sheet for hole location)
Red-brown, gravelly silt~(ML)
Perc rate = 275 ft.Z/bdrm.
Gray-brown, silty, sandy gravel (GM)
Per'c rate = 225 ft.'2/bdrm.
Gray-brown, clean sand with gravel (SW)
Perc rate = 125 ft.2/bdrm.
No water table encountered.
AVERAGE PERC RATE FROM SOILS LOG = 203 ft.~bdrm.
Date Net Time Depth Net Drop
6/2/76 5 min. 27 in. 9.5 in.
6/2/76 10 min. 19.5 in.
37 in.
79.5 in.
6/2/76 81 min. 62.5 in.
6/2/76 181 min. 87 in. 69.5 in.
Percolation Rate 2.60 minutes/in. = 70 ft.2/bdrm.
By , ~- _ALASI~ GEOLOGICAL CONSULTANTS£ INC.
b
. rC,[ B�
•-111C. , Municipality of Anchorag• u‹6 7 8 9 70 , ,f
On-Site Water and Wastewater Program ti i.,-, ;;- , .1 <..,o mil i i
(907) 343-7904
MAY 2 5 2018 3.
z
Certificate of On-Site Systems A. 0, .val
c.
� ti
Parcel I.D. 015-322-38 Expiration :''e& O."9� ��
1. GENERAL INFORMATION
Complete legal description Valli Vue Estates #2 Block 2 Lot 20
Location (site address) 6260 West Tree Drive
Current Property owner(s) Jerry L. & Steve C. Opsahl Day phone 907-441-4609
Mailing address 6260 West Tree Dr, Anchorage, AK 99507
Real Estate Agent Day phone
2. TYPE OF DWELLING:
0 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 0
Individual Water Storage ❑ Holding Tank ❑
Community Class A Well 0 Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: ( A-ni&
f.1 m/a Date: -51k1/8
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ 5)) .496 Waiver Fee $ a/5r.16
Date of Payment 572q l67 Date of Payment (512413
Receipt Number 04535D Receipt Number Ot S3S D
J
COSA# 3S C /7/A3A Waiver# 6bVG l la a6
•
114°. ,
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Forge Engineering Phone (907) 522-7773
Address PO Box 240773 Anchorage, AK 99524
Engineer's Printed Name Benjamin Schiller, PE Date 5/25/18
i*).4g TM j�
6. DSD SIGNATURE %••
System #1 Approved for bedrooms � . Beniamin Schiller :
715%. CE 12592 •c`'
System #2 Approved for bedrooms
��'sl�,:•.��aSJ�ta•���`�
Disapproved i1�\•���� -
Conditional approval for bedrooms, with the following stipulations:
G�Q , OF AA/C?x
°t7'
m
WATER AND
WASTEWATER o
PROGRAM
'14-4I7•carp\I\C .
By: Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet S c
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: Valli Vue Estates #2 B2 L20 Parcel ID: 015-322-38
A. WELL DATA
Well type Public If A, B, or C provide PWSID# 210605 Well Log (Y/N)
Date completed Sanitary seal (Y/N) Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L
Arsenic ug/L Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 1 1/21/03
Tank size 1000gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N
Date of pumping 9/05/17 Pumper A+ Home Services
C. ABSORPTION FIELD DATA
Date installed 5/23/18 Soil rating (g.p.d./ft2 or ft2/bdrm) 1 .2 System type 5-Wide
Length 39.0 ft. Width 5.0 ft. Gravel below pipe 4.0 ft.
Total depth 11 .4 ft. Eff. absorption area 390 ft2 Monitoring tube Y Depression over field N
Date of adequacy test New Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole/cleanout
Sewer/septic service line Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >� 0� Property line >5' Absorption field >5'
Water main Water service line >10Surface water >100
Wells on adjacent lots 100'
ABSORPTION FIELD ON LOT TO:
1* >10'
Property line 6.5 Building foundation Water main >10
Water Service line Surface water Driveway, parking/vehicle storage >10'
Curtain drain None Noted Wells on adjacent lots >100'
F. COMMENTS
*WAwe2 503m1M0
G. ENGINEER'S CERTIFICATION 4OF kt�
I certify that I have determined through field inspections and A*.• 1H4 '6
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date. A•.:
Benjamin Schiller, PE �r•
•• •�� nSchiller :
Engineer's
5/25/18ed Name I.,er,_... E.125V ..*(Z-
Al
Date �k PROFESSI��*4e
ANN•N.
COSA brown sheet 10-10-12.doc
Municipality of Anchorage {=s :
1lilr
U,.,,.„un c n i
P.O. Box 196650 ® 4700 Elmore Road
Anchorage, Alaska 99519-6650 a (907) 343-7904 ® Fax (907) 343-7997
http://www.muni.orq/Onsite
Development Services Department
On-Site Water and Wastewater Section
**** VARIANCE/WAIVER REVIEW ***
Waiver#: OSV181025 COSA#: Permit#: OSP181103
PID#: 015-322-38
Legal Description: Valli Vue Estates#2 Block 2 Lot 20
Engineer: Forge Engineering
Applicant: Jerry & Steve Opsahl
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the property line has been approved. The approved separation distance is 6.5 feet. See
engineer's waiver request letter for justifications.
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
Waiver is Granted: X Waiver is not Granted:
Date: 5/2-9/i Approved by: P.je.e,(1.<
Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
LOT 21
•
, I
S89° 54' 51"W 152.75' 30' I
4 CO __+ . N
N
Qa c>
x A3CO� xM •-)
0-) w I
LOT 13
m
O
I 59.T -
x 5 CO % 42.3' p
1- Z Q
C
v EXISTING N .............. poi. 0
vw Nam a.1' HOUSE '.'.'.':'.:.'..'. ...:.:...:.....:.........' w
L�YN1 - ...........::.....: .. .. . .. ..�.' I
1 i—
U J BRICK PATIO Y CO
rn 12.1' W
p t. . 4.0' II
\°� p ', o % M ROCK RETAINING WALL J
\�� op x 1 CO A 18.1' p
tri
up
<., I N
x ii
oo000ODO
o Q
4.' x LOT 20 o O F q� ��
Q`- o,�� ,q 4
F: 00
o S
�Oj x 30' p 4 9TH /\ ••.-7 0O
X
8.
1�
___---N80. 54 15 0 STEVEN CALLAGH•N: ,b
LOT 12 \ \ V0()(11)6)''0
s, • LS
�-11220 4 2',.;'
LOT
LOT 19 Q��°° �1�.1. `JpO
4� r°fession°� �a�
NOTE: ��OOoOo��
THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN
LEGAL DESCRIPTION: WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH.
250 H Street ADDRESS: 6260 WEST TREE DRIVE PARCEL#: 015-322-38-000
Anchorage,Alaska 99501
a LOT 20, BLOCK 2, AS-BUILT SURVEY CERTIFICATION:LCG LANTECH,INC HAS CONDUCTED APHYSICAL SURVEY OF
3, Survey Department VALLI VUE ESTATES UNIT NO. 2 THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE
Phone 562 5291 IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO
LEGEND: ENCROACHMENTS EXIST OTHER THAN NOTED.
Mainline
mill ili
InC DRAWN DATE: 5/29/2018 WORK ORDER: 18038 : : ••••Asphalt........
Phone 243-8985 � -----• CLEAN OUT #CO-- EXCLUSIONARY NOTE:IT IS THE OWNERS'RESPONSIBILITY TO DETERMINE THE
a'w'.Lcecc'ilLe• er Cr.e DRAWN BY: AP/MH/SC PLAT: 77-296
I Concrete ..
�� AECC 668 . WATER VALVE _:;1; EXISTENCE OF ANY EASEMENTS,COVENANTS.RESTRICTIONS OR RIGHT-OF-WAY
CHECKED BY: SC I GRID: SW2538Overhang :„ TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO
_ FENCE —X—X— : CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION,FOR
ORDERED BY: STEVE OPSAHL SCALE: 1"=30' I FB/PG:808/69 REF:96L96A Wood Deck ESTABLISHING PROPERTY LINES,OR FOR PLOT-PLAN PURPOSES.
* ) ' GE
ENGINEERING
PO BOX 240773
ANCHORAGE,AK 99524
522-7773 677-7766(FAX)
May 25, 2018
Municipality of Anchorage
Development Services Dept- On-Site Water& Wastewater Program
4700 Elmore Rd
Anchorage,AK 99507
Subject: Valli Vue Estates#2,Block 2, Lot 20—6260 West Tree Drive
Lot Line Waiver
Dear On-Site Services Engineer:
During the installation of the septic trench at this address, our inspector realized that the trench
was not quite going to fit between the existing trench and the lot line. Although the survey as-
built used for design indicated there was enough space, it didn't quite fit.
After discussions with on-site, we agreed to keep the 12' separation to the existing trench, taking
some space out of the 10' lot line separation. During construction, a portion of the side of the
trench collapsed slightly, requiring the contractor to fill that back with absorption rock. This
further reduced the separation to the lot line.
In the end, the trench ended up being located 6.5' away from the lot line at its nearest point. We
are requesting a waiver for that distance. The septic system is not encroaching on any well or
surface water radius, nor does it impact the septic system on the adjacent property. There is no
adverse consequence to granting this waiver.
Sincerely,
A'k ' 4 -.4
Benjamin Schiller, PE j",;*:•�TH �� *���
Benjamin Schiller : /
r#***. CE 12592 ...(<4.?'
c�slF• 5/25/18 .• „
tIkitPROFESSION�'����
MUNICIPALITY OF ANCHORAGE - -' - - '~- .......
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O, Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
,.Property owner'-- L
Mailing ad~ress ~. O. ~oX II 1~ ~
Lending agency
Mailing add~ess
Agent
Address
Day phone ~/~- ~c~73
Day phone
Day phone
~" '~' !~-_ .Unles.s, otherwise,, requested, HAA will be held for pickup. . :. ~ , .-_....- -
2.' NUMBER OF BEDROOMS: _"~ :
.3. TYPE OF WATER SUPPLY:
Individual well
....... ....... - ' Community well
Public water
NOTE:
\~ ;.
4. TYPE OF W~STEWATER DISPOSAL:
........... ': . .Individual on-s te I,/
Holding tank
. -c . Community on-site
'" ~' ~'~"-~" '"':' Public sewer
NOTE:'
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system. ~
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system. ~' " '
72-025 (Rev, 1t91) Front MOA ~21
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 of this Health Authority Approval application shows that the on-site.water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm I ~' ]~ ~ ~ u ¥ ~--~.~ ~ Phone
Engineers signature
6. DHHS~SIGNATURE
['/'~' Approved for
Disapproved..
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Commenm
'.' -r.~ ~A.~ ,.~o *,, ~,f ,~,~ch0rar~e Deuartment of Hea th and Human Services (DHHS) issues Health Authority
' ,~;;ro'~a'i'~;~i~i'~a';(~s?based ;nly u~on the representations given in paragraph 5 above by an independent
professional en,gi~,'~'registe re d in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfl/certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze-data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the p?ofessional engineer's work.
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDescription: /.cT ~2~,/~K ~'t I/'¢"'~"~ V'~x'~ ParcelI.D. 0/~ '~'Z.Z-'2-~oc~
If A, B, or C, attach ADEC letter. ADEC water system number ,~/0~ ¢ ~
A. Well Data
Well type /iA ti
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date completed Driller
Cased to Casing height
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level1
SEPARATION DISTANCES FROM WELL TO:
Wires properly protected (Y/N)
AT INSPECTION
g,p.m.
i-r1 (_o ~ ~o
~ ~o
Septic/holding tank on lot
Absorption field on lot
Public sewer main
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Sewer service line
Petroleum tank
WATER SAMPLE RESULTS:
Coliform Nitrate Other bacteria
Date of sample:
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed J ~ ~' I Tank size ! ~ Compartments
Cleanouts (Y/N) ~/ Foundation cleanout (Y/N) '~'/ Depression (Y/N)
Alarm tested (Y/N)
High water alarm (Y/N) ,
Date of pumping . /£~,~ Pumper ~-'~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
I-//.
Well(s) on lot
To property line
SUdace water/drainage
On adjacent lots
Absorption field
o
Foundation
Water main/service line
I0
72-026 (3/93)* Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical codes (Y/N)
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" Level at
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed I ~'! ~ /
Length ["~ ,~,.-
Tolal absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
Soil rating (GPD/FF) I ~ D
Width ~ Gravel thickness '7'
~-,~o°''' Cleanout present (Y/N) "/
7/~'/~d' Results (pass/fail) "~
System type
Total depth
Depression over field (Y/N)
for 3
After test '~' /
If yes, give date
/O
Bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot ' ?.//A
To building foundation
On adjacent lots
Sudace water
Curtain drain ~'~
On adjacent lots ("///A- Property line
~ To existing or abandoned system on lot h//A-
Cutbank t 0 Water main/service line /
Driveway, parking/vehicle storage area I 0
E. ENGINEER'S CERTIFICATION
I ceNfy that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature
Date
HAA Fee $ -'~c~)-
Bate of Payment
Receipt Number ////~
Waiver Fee $
Date of Payment
Receipt Number
72-026 (3/93)' Back
203 WEST 15TH. AVENUE SUITE 203
ANCHORAGE, ALASKA 99502-3904
(907) 279-3916
Fax (907)-276-601
SEPTIC SYSTEM ADEQUACY TEST
LEGAL:
LOCATION:
OWNER:
Lot 20, Block 2 Valli Vue Estates
6260 West Tree
Leonard Schultz
RESIDENCE: 3 Bedrooms Single Family
WELL: Community Water Systam
SEPTIC SYSTEM:
FROM MUNICIPAL RECORDS: 3 Bedroom System
TANK: Greer Tank 1000 Gal. 2 Compart.
ABSORPTION SYSTEM: Trench
ABSORPTION AREA: 588 Sq. Ft.
SOIL RATING: 190
INSTALLATION DATE: August 198i
WAIVERS GRANTED: None Required
DATE OF LAST PUMPING: Rote Rooter Isaacs, Anchorage Cesspool
DATE OF TEST: July 7, 1995
TEST PROCEDURE: This system was tested in 1988 and again in 1991 by this lmm. Both tbese two tests indicated
that the pipe at the end of the trench was not perforated below the horizontal distribution pipe. Both in 1988 and 1991
the liquid level in the pipe was 5 feet. Both times the system was tested by adding water to the trench until water was
observed flowing into the tank. In 1988 1900 gallons were added without observing water flowing into thetank.. The
water level in the standpipe rose 20 inches. In 1991 400 gallons were added to the trench before backflow to the tank
was observed. After a wait of 40 minutes another 90 gallons were added before backup occurred. After another wait
of three hour 85 gallons were added before backup. It was concluded in 1991 that the system was capable of absorbing
670 gallons per 24 hours.
On July 7, 1995 a 2-inch steel perforated probe was driven into the trench next to the double cleanout after the tank.
I0 gallons of water was added to this probe to verify that the probe was into the gravel. The 10 gallons flowed readily
out of the probe. It was observed that the tip of the probe was 2.5 feet below the invert of the cleanout. Water was
added to the trench at a rate of 10 gallons per minute until backup into the tank was observed. Approximately 1500
gallons were added. A small amount flowed into the tank, raising the water level in the tank 4 inches. Both the tank
and the trench had been pumped prior to this test. Water was observed at 70 inches below the top of the steel probe.
After a period of 6 hours water was again added to the trench. The water level in the probe was now 84 inches below
the top. After adding 140 gallons the water level in the probe was at 70 inches and flow into the tank was observed.
From this it was concluded that the absorption rate &the trench was 23 gallons per hour, or 560 gallons per 24 hours.
12 hours later 230 gallons were added before backup was observed.
TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the
Municipality of Anchorage.
NOTE The operational life of all septic systems depends on the local soil conditions, 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 this septic system. We can therefore not give any estimate of how long this system will
function satisfactory for current or future occupants. All septic systems ultimately fail. Some systems last 15-20 years,
others fail after less than 5 years.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions
Property owner
Mailing address
'Lending agency
Mailing address
Agent
Address
Day phone
Day phone: '
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: -~
TYPE OF WATER SUPPLY:
Individual well
Community well '~
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
lng to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site /
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev, 1/91) Front MOA #21
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 of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Phone ~1-7r/- ~ ~ /~
Address
Engineer's signature
DHHS SIGNATURE
'/~ Approved for -~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
By:
Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The D H HS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72q)25 (Rev. 1/91) Back MOA~21
203 ~EST }SlH. AVENUE SUITE 206
ANCHORAGE~ ALASKA 99502-3904
(907) 279-3916
Municipality o.F Anchc)rage
DivisioF) o-F Envirenmental Heal th
Depar"tment o~ Health and Social Services
820 L Street
Anchc)rage~ Alaska 99501
November 26~ 1991
Sub j ect:
Retest o~ sept:Lc system
Lot 20,; Block 2 Valli Vue
6260 West Tree
Gentlemen;
Per' your request the septic system on subject lot was retested on
Nov. 19~ 1991. T'he reason ,~er the retest was to validate a test
per-Formed on August 11~ 1991. There was some concern if Hydrogen
Peroxide had been used at that time.
The test eT Nov,, 19, indicated that the system is serving satis-
Yactory ~or a three bedroom I~ouse.
RECEIVED
NOV 1]B1
I~.; ~ u u~h[y ot A~lchorage
Dept. Health & Human Services
'l-.. S F:'LJF{~])--~P.-tl~J~ F~ ., E;.,
20H ~EST 15YH. AVENUE SUITE 206
ANCHORAGE, ALASKA 79502-3g04
(907) 279-3916
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WELL:
SEPTIC SYSTEM ADEQUACY TEST
Lot 20, Block: 2 Valli Vue Estate
6266) West Tree
Leonard Sc::hulzt
Single Family~ 3 Bedrooms
Class A PWSID 210605
SEPTIC SYSTEM:
[:ROM MUNICIPAL RECORDS: 3 Bedroom System
TANK: Steer Steel 1000 Sal. 'T'we Comparts.
ABSORPTION SYSTEM: Trench
ABSORPTION AREA: 588 Scl. Ft,
SOIl_ RATING: 19(.)
INSTALLATION DATE: 8/22/81
DATE OF LAST PUMPING: Isaacs Nov. 19~ 1991
DATE OF TEST:
Nov., 19~ 1991
TEST PROCEDURE: System was inspected and measured on November
15~ 1991. Tank was found with 4 feet of cover and with a liquid
ievel of 48 inches. Trench cleans out were 5.6 feet deep and dry.
Trench monitor tube was found filled with soil at a depth of 4
feet below gr'oLInd. Monitor was cleaned out to a depth of 9 feet.
At that depth 5 feet of water was measured in the tube.
575 gallor)s of clean water' was added tr.) the trench att a steady
rate of 1(]) gpm while the water levels in the tank and the monitor
tube were monitor'ed. Backup into the tank was observed a~ter
adding 400 gallons. The filling was stopped ~or 40 minutes~ then
resumed. 90 gallons were added before backup was observed aga:Ln.
The water level in the moth,tar/sump was at +28 when bacl<up oc-
curred.
A~t. er a three hour rest another 85 gallons were added before
backup was observed.
After 17 hours the water' level in the sump was at +7, indicating
that appr-oximately 475 gallons had been absorbed.
TEST RESULT: 'Finis system meets the code requirements of
the Nealth and Social Services
Department o'F the Municipality of Anclnorage.
NOTE The operationol life of all septic systems depends on the lo~al soit conditions, groundwater levels that
may ~luctuate during ~he year, and the ~ater ~sage of the family being served by the system. These ~onditions
are outside the control of the evaluator of this septic system We can therefore not 0ire any estimate of ho~
long this system will function satisfactory for current or future occupants.
MEMO
DATE: September 11, 1991
TO: All Parties Concerned
FROM: John Smith, On-site Services ~u~~V1''7-~
RE: Lot 20, Bk 2, Valli Vue Estates No. 2
Conditional Health Authority Approval
Ail parties concerned are advised that the subject Health
Authority Approval is issued with the condition that the
absorption system adequacy be retested after the existing system
has been utilized for 90 days° Should the system pass the
adequacy test, the conditional approval will convert to an
unconditional approval. If the system fails the adequacy test,
the conditional Health Authority Approval will expire and the
system will require upgrading. DHHS must be notified at least
48 hours prior to the retesting of the system.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D.# ~)[~---- "~'~2. -- .~'~ HAA# ~c~,
i. GENERAL INFORMATION
Complete legal description
Location (site add'ress or directions)
PropertyiOwner
Mailing address
Lending agency
Mailing address
Day phone
Agent
Address
Day phone ,
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: ~-~
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91 ) Front MOA ~I~21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water '
supply ~nd/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
EngineeCs signature ~~~~ Date
Disapproved.
X Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By: -..~C) H N.L ,..~¢. ~ 1'I-~ Date c~////..~,)
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
A. WELL DATA
Well type t~' If A, B, or C, attach ADEC letter.
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Parcel I.D.
ADEC water system number
Log present(Y/N)
Date completed Driller
Total depth Cased to
Casing height
Sanitary seal (Y/N)
Wires properly protected (Y/N)
Date of test
Static water level
Well flow
Pump level
FROM WELL LOG AT I_I_I_~SPECTION
~.~.~/~'~ ,MI~NICIPAUTY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer service line
g.p.m.
j~fi' adjacent lots
,~ ; On adjacent lots
.~ Public sewer manhole/cleanout
~ Petroleum tank
g.p.m.'
!!CEIVED
WATER SAMPLE RESULTS: /~t,//~
Coliform Nitrate
Other bacteria
Date of sample:
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed
Tank size ~)O J~ O ~ / Compartments ~"
Cleanouts (y/N,); ~. 'i~ ~*
;;~ ': Foundation cleanout (Y/N) -- Depression (Y/N)
High water alarm (Y/N)';' , ([rr- Alarm tested (Y/N)
Date of pumping , Pumper '
SEPARATIO~ DISTANCES FROM;SE~IC/HOLDING TANK TO:
Well(s) on lot ~ .... .- ,~' ~n adjacent lots Foundabon
To property hne I ' Absorption field ~ Water main/service line
Surface water/drainage ¢ ¢~ ¢~ ~ C ¢'' r~¢=)
72-026 (Rev, 7/91)Front ' CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
Manufacturer /
Manhole/~.~~
"Pump on" level at .-/" "Pump off" level at
High water alarm level ~ Cycles tested
Meets MOA electrical codes (Y/N)~...~~-
SEPARATION DISTAN/OE~OM LIFT STATION TO:
Well on lot /.~'~J On adjacent lots Surface water
D. ABSORPTION FIELD DATA
Date installed ~'' 81
Length ~[~/ Width
Total absorption area
Depression over field (Y/N)
Results (pass/fail) _
Soil rating
Gravel thickness
Peroxide treatment (past 12 months) (Y/N)
Cleanouts present (Y/N)
Date of adequaoy test
for ~
-I (~ If yes, give date
System type I (' '
Total depth / (f~ (
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot /'/~t-
To building foundation
On adjacent lots ~
On adjacent lots ~ 0 0 '~ Property line
I ~'~' To existing or abandoned system on lot
Cutbank /k¢///~ Water main/service line
Surface water
Curtain drain
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
HAA Fee $ / ~/~ Waiver Fee: $
Date of Payment ~' ~-~? ~ ~/ Date of Payment
Receipt Number ~ ~ -~' '5~,~/ Receipt Number
72-026 (Rev. 3/91} Back MOA 21
DEPT. OF ENVIRONMENT/kL CONSERVATION
ANCHORAGE DISTRICT OFFICE
3601 C STREET, SUITE 322
ANCHORAGE, ALASKA 99503
August28,1991
WALTER J. HICKEL, GOVERNOR
563-6775
PWSID 210605
My review of the records on file in this office reveals that the Valli-Vue Subdivision Class
"A" Public Water System, is in compliance with the provisions of 18 AAC 80.200, State of
Alaska Drinking Water Regulations.
Sincerely,
Keven K. Kleweno
Lead Engineer
I
. ~AU8 28 '91 i4:49 ROTO ROOTER
I~.O. BOX I~2688 ANCHORAGE, ALASKA 99511-2688
Auguet 28, 1991
TO Whom It May Concern:
On AuguSt 23, ~991, our company wag cal~ed to 6~0 west
Tree Drive by Mr, Craig 8uchl~nd.
This call wee handle4 by ou~ service me~ Jack Shaw, Ben
ColliNs and Wayne Whitake~. The septic tank was pumped
and wa~ found to ~oDtein light sludge, ~ At that time
they als0 used our high pressure water ~et to clean out
the leaGh line from back to back ~lean Ou~s fro~ sai~ leach
field,
we ~id not use peroxide in the treatment of thf~ leach
field,
Sincerely,
INVOICE
SEWER AND DRAIN
BOX 11~ PHONE ~13 AN~HORAG
R QTO-R00T~R,, ,~,ER¥1C E CAI .I.
~M THAWING HRS__.
~PING 8~CE (GAL) HRS.
** TOTRL PRGE.O01 **
MU.,CIPAU OF A.CHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROV. A1-
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date'
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Loc~t,o. (address or directions) ~ L
(b) Property Owner ~', 'Pb~x' Telephone: Home
Mailing Address
(c) Lendinglnstitution ~I~A'"~-- !~;.~ ~ Telephone
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
(e) Mail the HAA to the followina address: or; Check here~ if hold for pick up.
List contact person and day phone number below.
Business
TYPE OF RESIDENCE
Single-Family~
Number of Bedrooms
WATER SUPPLY
Individual Well [] Community,~ Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the Jegarity and status.
SEWAGE DISPOSAL
Onsite ~, Public [] Community [] Holding Tank []
!
Note: I~com munity well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 inev 8/861 Front
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affi×ed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with a~l Municipal and State codes, ordinances, and regulations in effect on
the date of this
Name of Firm ~~ Telephone ~- "~ ~"
Address / ,¢~-'0 ~ ~ ~,...~'~./
Seal
D..S APP.OVA, /¢./,./ ., //
Approved for ~/.n ..~.)bedrooms by ~'/_/,~/f./--~. ~,~.~-~f'~ Date
Approved ~_/4~__ Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cedificates based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes and their lending institutions in
order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data
before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional
engineer's work.
Page 2 of 2 72-025 fRev 8/86) Back
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments
. ~c'°. 9\q\$'~IUNICIPALITY OF ANCHORAGE (MOA)
,,.?[ O~: '~-~',c-.,~'''~ HEALTH AUTHORITY APPROVAL (HAA)
~\G\,~ ~...,~.t ~.~?gY,.~x~ ,~ CHECKLIST - FEBRUARY 1984
~,,3~,~.~ ~. \~) 264-4744
\~ . I~ Legal Description: /.,O/ ~O
WELL DATA ~
Well Classification ~ ~ If A, B, C, D.E.C. Approved (WN) ~
Well Log Present (Y/N) Date Completed Yield
Total Depth Cased to Depth of Grouting
Static Water Level Pump Set At
Casing Height Above Ground Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit}Y/N) Depression Around Wellhead (Y/N)'
Separation Distances from Well:
To Septic/Holding Tank on Lot · ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots
To Nearest Public Sewer Line To Nearest Public Sewer
To Nearest Sewer Service Line o~ Lot
B. SEPTIC/HOLDING TANK DATA
Date Installed ,~u..,~/
Standpipes (Y/N) 3'u~
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water A/arm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line J D
Course
Size I ~ OC~ No. of Compartments
Air-tight Caps (Y/N) ~' Foundation CleanQut~(,~_) ~"~
Date Last Pumped ~/~/~
I'~/~., ;for
Temporary Holding Tank Permit (Y/N)
To Building Foundation I J
To Disposal Field I t~)
To Stream, Pond, Lake, or Major Drainage
Comments
Page I of 2
72-026 (Rev. 8/861 Front
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Uatelnstalled __ A~
Width of Field
Square Feet of Abserption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot /V 0 N
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line I ~;)
To Existing or Abandoned System on
; On Adjoining Lots / ~ -'~
To Cutbank (if present) ~/ov/~_.
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N}
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified,,,~r conformed to all,,MOA a~d HAA guidelines in effect on the date of this inspection.
Signed
Company MOA No.
Date of Payment
., .- ~. . Engineer's Seal
Page 2 of 2 . '
360~ C 8TREET~ SUITE ~33a
ANCHORAGE~ ALASKA 99503
STEVE COWPER, GOVERNOR
563-6775
DATE: April 25, 1988
PUSID: 210605
To Whom It May Concern:
According to the records on file in this of?ice, the VALL1-VUE
SUBDIVISION Water System is in compliance with the State o?
Alaska Drinking Water Regulations.
Please note that departmental records indicate that the public
water system was installed prior to the 1978 implementation of
the Alaska Drinking Water Plan Review regulations. No as-built
plans have been reviewed or approved by the department, nor are
any necessary. Since the system has submitted acceptable water
samples on a regular basis and received a satis?actory sanitary
survey evaluation by the department, the system is acceptable
under the standards in effect at the time of installation. An
official "Certificate to Operate" may be issued upon receiving a
complete set of as-built plans. Any expansion o? the water
system a?ter 1978 will require plan review and the issuance of a
"Cerii?icate o? Operation" permit.
Sincerely,
Michael P. Lewis
Environmental Engineer
MPL:pkk
CONSULTING ENGINEER TELEPHONE: (907) 279-3916
SEPTIC SYSTEM ADEQUACY TEST
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WELL:
SEPTIC SYSTEM:
Lot 20, Block 2,
6260 West Tree
Bruce Phau
Single Family,
# bedrooms
Class A Community System
FROM MUNICIPAL RECORDS:
TANK: Greer Steel, 2 Comp. 1000
ABSORPTION SYSTEM: Trench
ABSORPTION AREA: 588 sq. ft.
SOIL RATING: 190
INSTALLATION DATE: August 1981
gal.
DATE OF LAST PUMPING: April 25, 1988
DATE OF TEST: April 25, 1988 ~-'-z~ ~/$__~F~~/~
TEST PROCEDURE: System was inspected and measured. Tank was
found with four feet of cover and a water depth of 50 inches.
Sump was 9 feet deep and also had 50 inches of liquid.
500 gallons of clean water were add to the sump. This caused
t~ level to r~ise 20 inc~s. During the next hour the
level dropped 4 inches. During the next two days the level
dropped another 10 inches. On ADril 29 70~allons were added to
the system wmtn ~ rmse of,20 mnches and no inflow into tank.
Next day 700 gallons were again added. No overflow or flow into
tan~. -- ,~
The observations made during the test indicates that the sump is
not perforated and that the water level in the sump is not an
indication of the water level in the trench.
TEST RESULT: This system meets the code requirements of
the Health and Social Services Department of the Municipality of
Anchorage.
NOTE The operational life of all septic systems depends on the
local soil conditions, 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 this septic system. We can therefore not give any
estimate of how long this system will function satisfactory for
current or future occupants.
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR I NSP ECTOR INSPECTOR
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHO~AGE
' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH &
t 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION
ENVIRONMENTAL SANITATION DIVISION AUG 1 9 1981
· Telephone 264-4720
)IRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
PHONE
PROPERTY RESIDENT (If different from above) , PHONE
2. BUYER PHONE
MAI LING AD DR ESS
3. LENDING INSTITUTION PHONE
MAILING ADDRESS
4. REALTOR/AGENT , PHONE
MAILING ADDRESS
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four [~] Other~
Ii--SI NG LE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six
7. WATER SUPPLY
[] iNDIVIDUAL* * ATTACH WELL LOG, A well Icg is required for all wells drilled
[~'~OMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM
[~]~DIVIDUAL/ON-SITE** ~i' I YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTI LITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72 OIO (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
' 1. TYPE OF RESIDE{NCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[~INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or ~] Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nealest Lot Line
5. COMMENTS
[~APPROVED FOR 3 BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE ' BY
ALASKA
9950'
~..,. ?, 2644111
December 31t 1979
John Mottsinger
3650 Alamosa
Anchorage, Alaska 99502
Permit ~ 790378
Subject: Lot 20 Block 2 Valli Vue Estates Subdivfsion
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 welt 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. Suchholz, R.S.
Senior Environmental Specib~st
LNB/ljw
enc: Copy of Permit
December 29, 1978
9780771
Jerry Hardin
9024 Hartzell Road
Anchorage, Alaska 99507
Subject~ Lot 20 Block 2 Valli Vue Estates Subdivision ~2
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 there s~e any further questions, please contact
this office at 264-4720.
Sincerely,
Les N. Buchholz,
Senior Environmental Specialist
LNB/ljw
enc: copy of permit
October 24, 1977
~76855
John Motsinger
535 N Street
Apartment ~1
Anchorage, Alaska
99501
Subject: Permit Expiration
Dear Mr. Motsinger:
A pe~nit issued by this department for well and/or on-site
se.~er installation on Lot 20 Block 2 Valli Vue Estates
Subdivision ]las expired since the issue date exceeds one
(t) year.
In the event you still pl~% to install the well and/or on-site
sewer system~ a new permit is require~!. The original soil
test may be used to obtain a ~urrent permit.
If the well has been drille~, a well log should be sent to
~is depar~lent to doc~Rent the installation date.
If you have any questions regarding the above matter, please
do not hesitate to contact this office i~m%%ediately at 264-
4720.
Sincerely,
Les N. Bucb~holz~ R.S.
San itarian
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CERTIFICATE '.OF OWNERSHIP a DEDICATION;
We hereby ce~ify' that vie are the owners of the pro-
party shown and described hereon. We hereby
request approval of this plat, showing such ease-
ments for oublic' utilities, roadways end alleys
NOTARY'S ACKN(
Subscribe-d and sworn
->-~ f-~. '__d~