HomeMy WebLinkAboutVALHALLA BLK 1 LT 4
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP241295
Work Type: SepticTank Upgrade
Tax Code Number: 01521233000
Site Legal Address: VALHALLA BLK 1 LT 4 G:2736
Site Mailing Address: 12230 SHENANDOAH RD, Anchorage
Owner: HOPE COTTAGES INC
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
Effective Date
Expiration Date:
�111ell
t.
r.4 n
L)epare�nettt
Lot Size in Sq Ft
Total Bedrooms:
9/17/2024
9/17/2025
❑ Disposal Field ❑ Septic Tank Q Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
CA
Received By: ��^^ Date: cr
Issued By: `�I C Date: Z
ON -SITE 8EPOC&VELLPERMIT APPLICATION
Parcel I.D. 015-212-33
Ho
pe rroperq/owner�H'
) Cottage Day phone 907-433-4733
Mailing address 1223O8HENANDOAH°ANCHORAGE./\K
1223OSHANENOOAH-AN��H(}����AK
Site address '
Legal description (Sub'd..Block & Lot) VALH/\LLA;BLOCK 1.LOT 4
Legal description (Townohip. Rmnge& Section)
Lot Size Sq.FL Number ofBedrooms 4 (5mfuture)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OFDWELLING:
(gall that apply)
Absorption Field Fl Initial
Single Family (SF) El
-_
--
�vhwoAOU)
3eoboTon� �� Upgrade
� °—^
p�
--
�
Oup|ex(O\ �]
Holding Tank �� Renewal
��
^~
'
Multiple Dwellings Fl
--
Privy��
(SF and/or D)
Private Well �]
Water Storage �]
THIS APPLICATION INCLUDES AWAIVER REQUEST FOR:
Diotanm*:_____
| certify that the above information is correct. | further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 7 Z S—
Waiver Fees:
Date of Payment:
Date of Payment:
Receipt Number:
Receipt Number:
Permit No. 2- 9
Waiver No.
uADevempmentmervices\Bmldinooafety\oSite Water and mrmsTerTnnApplication.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241295, Curtis Townsend, 09/17/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241295, Curtis Townsend, 09/17/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241295, Curtis Townsend, 09/17/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241295, Curtis Townsend, 09/17/24
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701E. TUDOR ROAD, SUITE 101-ANCHORAGE, AK 99507- PHONE (907)337E779 -FAX (907)338-3246-WEBS ITE:-ga.e .gineemg.
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: VALHALLA; BLOCK 1, LOT
PERFORMED FOR: HOPE COMMUNITY RESOURCE INC. DATE. 8/9/2016
DEPTH —
(feet) —
ORGANICS
1
2
3
4
5
ML
s
7
8
9
10
11
12
B.O.H.
13
14
15
16
17
18
SEEMS awlyl
•
�11
II�'ll�ll
i//i
MEN
•�• •'. •.
1II'I1III
qv//0
DEPTH TO
GROUNDWATER
DATE
2 FEET
8/9/2016
2 FEET
8/16/2016
I i
I
I �
I loo'lq _--_
/
ISEPTIC MEAD
I VALHALLA; 6LOG��Dlus
`
I i
I (10
0, !0ao
LJ
I T.H.2 ��--
O
I N
J
I VALHALUj� B2QCK 1, LOT 3
Ld
I I RPO�US
I
10
i
�
I vJ�La. SCA
CSEPTIL
I �
I �
DATE
READING
CLOCK
TIME
I NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
8/9/2016
THE LIQUID LEVEL IN THE PERC HOLE DID NOT DROP DURING THE 4 HOUR PRE-SOAK.
19 PERCOLATION RATE >120 (MIN./INCH) PERC. HOLE DIA. 6
TEST RUN BETWEEN 2 FT. AND 3 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO
SOILS LOGGED BY: DAVID GARNESS PERCOLATION TEST PERFORMED BY: LANDON BRUCE
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FORZED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:6
(INCHES)
GARNESS ENGINEERING GROUP, Ltd
- CIVIL & ENVIRONMENTAL ENGINEERS
3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE. AK 99507 -PHONE (907) 337Ei79 - FA%(907) 338-3246 - WEBSITE: x gamessengin Mg.mm
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: VALHALLA; BLOCK 1, LOT 4
PERFORMED FOR: HOPE COMMUNITY RESOURCE INC. DATE: 8/9/2016
DEPTH —
(feet) _^^ ORGANICS TEST HOLE #1
1
SOIL CLASSIFICATIONS
2
.:
GP
ML
3
.
GM
CL
4
GC
OL
Do '0' o
SW
MH
5
c
': �'•;•
SP
CH
ML
SM
��,'
OH
6
SC
7
8
9
10
s.o.x.
11
12
13
14
15
16
17
18
DEPTH TO
GROUNDWATER
DATE
3 FEET
8/9/2016
1.7 FEET
8/16/2016
I �
I �
I �
I 100'lVF ----
C�EPTIC ARE �A
VALHALLA; 6LOOO 1, LOT 5
`
I�
I
100, B
a0
1
W
Of
I T.H.2
O
I �\ N
J
I VALHALLFII; B2QCK 1, LOT 3
w
I I RPpNs
1 1p0, NEB SCA
1
0'
CSIFPTIC AR. ,"-1
I \
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
8/9/2016
THE LIQUID LEVEL IN THE PERC HOLE DID NOT DROP DURING THE 4 HOUR PRE-SOAK.
19 PERCOLATION RATE >120 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 1.5 FT. AND 2.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: YES ❑ NO 0
SOILS LOGGED BY: DAVID GARNESS PERCOLATION TEST PERFORMED BY: LANDON BRUCE
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FO MED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: �,
--------------------------------------------------------
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Municipality of Anchorage Page __ of_
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~v,/,~c,.~.~fi2 PID Number:
r~,me:~g.~¢C. CJ . ~il~' Wastewater System: / ~ New ~ Upgrade
Address: ~ ~~ ~,, ~. A~ ABSORPTION FIELD ~/~
Phone: ~.~¢ I~o.o~drooms: ~Trench ~ Shallow Trench BBed BMound_~
Soil Rating. Total Depth from origi rede:
Lot: Block: Depth to pipe bottom from ' 'hal 9cede: Grsvel de eneath pipe
~ Range? ~ ~f~on; Fi, neat, pipe Ft.
Yield:~ ~,' 6,M ],umpSe;~. ,L OasingHe'ghtAb°veGr°un':~.~ ,t.
SEPARATION DISTANCES ~ Septic ~olding ~ S.T,E.P.
To Septic Absorption Lilt Holding Public/~rivate Manufacturer: Capacity in gallons:
Well ~t/~ ~E ~/~ ~ ¢'¢/ >J ~/~ M~ Number of ~ Compartments:
SurfaCewater ~1~' LIFT STATION ~/~
Lot ~faoturer:
Line ~ ~¢ I "Pump on" level at: '~ High water alarm at:
Foundation ~ ~¢ I
C~;:~n ~/~ ¢/~ Pump~ectrical Inspections performed b~
Remarks: I~ ~¢~W ¢~/ I~[~¢¢ ~ BENCH MARK
' " / Location and escriptio :
Inspections performed by: ~z/~ Dates: lst~
Department of HealthOn~ Hula erwces apprqval
Heviewea anu ~pp u Y: /¢]' ¢ . ~" ~ :
72-013 (Rev 9/91) MOA 25
Permit No. 49,/ ~0~,,~0 Page of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description:
PID No.:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PAGE 1 OF 1
PERMIT NUMBER:SW930280
DESIGN ENGINEER:ANDERSON ENGINEERING
OWNER NAME:WILBUR RICHARD R &
OWNER ADDRESS:12230 SHENANDOAH RD
DATE ISSUED: 8/10/93
EXPIRATION DATE: 8/10/94
PARCEL ID:01521233
LEGAL DESCRIPTION: ~VALHALLA BLK
1 LT ~ 4
LOT SIZE: 20000 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
HOLDING TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THIS PERMIT IS MODIFIED FROM A BED TYPE DRAINFIELD TO A
3500 GALLON HOLDING TANK
RECEIVED BY:
ISSUED BY:
DATE:
DATE:
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, ALASKA 99524
October 17, 1993
Municipality of Anchorage
Department of Heath & Human
825 "L" Street
Anchorage, AK 99502-0650
Services
R£C£1VED
Munic pality ot Anct~orage
Dept. Health & Huma ~ Services
Attention: Robbie Robinson
Subject:
Lot 4, Block 1, Valhalla Subdivision
Septic System Permit
Dear Mr. Robinson:
Initial excavation on the subject lot for placement of the septic system
revealed soils not consistent with the system design. We anticipated a
substantial portion of the existing bed system would remain in tact and
could be reused for the new system. The old mound, however, consisted of
very little gravel material and was completely removed.
The underlying material was a dense silt (ML) and percolated at a rate
greater than 60 minutes per inch. A conventional system cannot be placed
on this lot. We are, therefore, intending to install a 3,500 gallon holding
tank to serve the three bedroom home. The attached site plan indicates
the area of placement for the tank. Installation of the tank is scheduled to
begin on Wednesday, October 20, and should be completed shortly
thereafter. Please let me know if you have any further questions or
comments.
Sincerely,
Michael E. Anderson, P.E.
CALCULATED BY.. DATE
CHECKED BY
DATE
Lot 4, Block 1, Valhalla Subdivision
Scope of Work
1. Pump existing 1,000 gallon septic tank, disconnect inlet and
outlet lines, remove and dispose offsite.
2. Install new M.O.A. approved 3,500 gallon holding tank with
alarm system. Piping shall be ASTM D3034 P.V.C. or ASTM
D2661 A.B.S.
3. Tank hold downs shall be per tank manufacturer's
recommendations.
All materials and workmanship shall be in accordance with
A.M.C. Chapter 15.65 Wastewater Disposal Regulations and in
particular Section 15.65.070, Holding Tanks.
5. Electrical fittings and connections for wiring of the high liquid
level alarm shall meet NEMA requirements for a water tight
service.
6. The alarm light and beeper/siren shall be located in the garage
or under the kitchen sink.
7. Regrade yard to preconstruction condition.
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW930280
DESIGN ENGINEER:ANDERSON ENGINEERING
OWNER NAME:WILBUR RICHARD R &
OWNER ADDRESS:12141 WOODWAY CIRCLE
ANCHORAGE, AK 99516
DATE ISSUED: 8/10/93
EXPIRATION DATE: 8/10/94
PARCEL ID:01521233
LEGAL DESCRIPTION: VA~LHALLA BLK 1 LT 4
LOT SIZE: 20000 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THE SAND USED IN THE SAND FILTER LAYER MUST BE A CLEAN
COURSE SAND WITH 5% OR LESS PASSING A #100 SIEVE AND 2%
OR LESS PASSING A #200 SIEVE. A SIEVE ANALYSIS MUST BE
PROVIDED ON THE SAND USED.
RECEIVED
ISSUED BY:_
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, ALASKA 99524
July 26, 1993
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject:
Lot 4, Block 1, Valhalla Subdivision
Septic System Design
hnpacts to Adjacent Properties
Dear On Site Services Engineer:
The drainage mound on the subject lot has failed and requires
replacement. It was originally installed in 1981 and has apparently
worked well since that time. No other areas on the lot are suitable for any
type of drainfield due to the high water table in the subdivision. The only
feasible onsite system other than a holding tank is to rebuild the existing
mound to current standards.
The original mound was constructed using approximately 4 of clean pit
run gravel· The drainfield rock and distribution pipe was placed directly
atop the gravel. We are proposing to remove the distribution pipe,
drainfield rock and any contaminated gravel from the mound. The
contaminated gravel will be replaced with clean Type II gravel. The
mound will also be expanded 5' to the east to provide additional drainage
area. A minimum 1' of coarse sand will be placed atop the gravel base and
the new drainfield rock and distribution system installed above the sand.
The new system will be a minimum 5' above the highest recorded ground
water in the area.
The existing septic tank and lift station will be exposed and inspected for
defects. If necessary, they will be replaced or repaired to acceptable
operating standards. Contaminated materials removed from the old
mound system will be disposed in Star Pit in an area at least 4' above the
water table. These materials will be treated as necessary to prevent
further contamination to surrounding materials and will be buried.
Lot 4, Block 1, Valhalla Subdivision
July 25, 1993
Page Two
Since the previous system worked effectively for the past 12 years we feel
the new upgraded mound should also function adequately for a
reasonable amount of time.
If the system is constructed in accordance with the attached design the
following statements can be made:
The system, if constructed as designed, will have no adverse impact
on the wells currently in use or to be placed in the future on lots in
the area.
2. The system, if constructed as designed, will have no adverse impact
on existing septic systems in the area or those to be constructed in
the future.
4
The system, if constructed as designed, will have no
on reserved space, either surface or subsurface, on any
the area.
adverse impact
lots located in
4. The system, if constructed as designed, will have no adverse impact
on drainage patterns in the area.
Sincerely,
Michael E. Anderson, P.E.
SHEET NO.
OF
DATE
CALCULATED BY /~ DATE
CHECKED BY, BATE
S~ALE
SHEET NO.
DATE
NOTE:
Remove existing 4" perforated pipe and drainficld rock.
Remove all existing material to below existing ground.
Dispose material at approved offsite Iocatioa.
Treat contaminated material as necessary to achieve proper pH.
Expand existing mound to 15' wide X 55' long.
Place 5' of coarse graded sand filter.
Place 6" of drainficld rock.
Install 1" PVC Distribution Pipe.
Place 2" Dow HI Styrofoam Insulation atop drainficld rock.
Place minimum 1' natural fill atop insulation.'
Place topsoil and seed atop natural backfill.
Grade to drain away from mound system.
Municipality el AnchQrage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOLES LOG -- PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19-
20-
DATE PE
Township, Range, SECtion:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
DEPTH?IF YES. AT WHAT
O~pLhmW~'ukfl4r~l"~'lkq~l~inO? 'r, ? O,ite:ljll~i'~'~
Gross Not Depth to Net
ReadillO Date Time Timo~.lt~,~
~ ~:~p IO I~. ~ ~.o
~ ~ fl~:fl ~ L~/~.1~ ~,~
~ l~l' ~ 19.~ ~.~1
PERCOLATION RATE ~ (mlnUte.5,'inch} PERC HOLE DIAMETER
TEST RUN eETWEE. .AND FT
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. OATP;
72-008 (Rev. 4/85)
February 23, 197'I
R & M No. 751111
Mr. Dan Wiese
SRA Box 1542W
Anchorage, Alaska
99507
Test Holm and Soil Log Report for Sanitary System
Lots 4 and 5, Block 1, Valhalla Su~xlivision, SW%, Section 22,
Ti2N, R3W, S.M. Anchorage, Ala:;ka
Dear ~. Wlese:
We are submitting herewith the test boring results and our comments
regarding soil comJitions encountered at the subject site. This
investigation was performed in accordance with your ~equest of
February 17, 1977 and thoss procedures outlined iea letter dated
July 15, 1975, by Mr. Roll Stickland of the Municipality of Anchorage,
Department of Environmental Quality.
A single test hole was bored on each lot within the subject area for
the purpose of definin.~ general subsurface soil conditions for the
prol~sed sanitary systems. Excavation was accomplished with an auger
type drilling rig and each test hole was extended to a total depth
of 20 feet below ground s~rface. ~e final logs prepared for the
test holes have been included in Drawing A-02.
Groundwater was encountered in each test hole while drilling. In
Test Hole 1, groundwater was encountered at 13 feet. In Test Rolo
groundwater was encountered at 14 feet below ground surface.
A percolation test was performed from a depth indicated and reflects
average infiltrotion from that depth to the bottom of th~ hole.
We appreciate being given this opportunity to be of service to you.
Should you have any questions with regard to the above, please do not
hesitate to contact us.
Very truly yourg,
R & ~! CONSULT~d~TS, INC.
James W. Rooncy
Vice Pregidnn t
J
/,,r~ 3
~OT2
?est IIole locations ar. approxinat, e
and have no~ been located b~
survey rm~hod~.
Lot.q 4 an¢!
Valhalla
TI{-1
PERCOLATION TEST
LOt 4, Block 1, Valhalla Su~!ivisi3n
Anchorage, Alaska
R & M No. 751111
ELAPSED
TIME TIME INCHES
3116 0 1O.00
3117 I 11.25
3110 2 12.00
3119 3 12.50
3120 4 12.75
3121 5 13.0
3:22 6 13.125
3:23 7 13.25
3:24 8 13.375
3125 9 13.50
3126 10 13.75
3131 15 14.50
3136 20 15~00
3141 25 15.50
3156 40 17.25
4:06 50 18.25
4116 60 19.~25
DROP 1N
INC~]ES
O.C=O
1.25
2.00
2.50
2.75
3.00
3.125
3.25
3.375
3.50
3.75
4.50
5.00
5.50
.._,f~125
?.25
8.25
9,125
6.58 Minutes Per Inch
, 3.0'
S~T ~SO~ SAND
~ist, O~casion~l Cobble
~
SANDY SILT
Brown~ %.foist
SANDY SILT
W/TRACE GRAVEL
tlofst, Mediu~ Dense
W/TRACE GRAVEL
Moist
Boulder at O!
.......... 11.0'
...... 10.0t
13'W.D.
SILTY SAND
W/T~ACE GRAVEL
Moist, Medium Dense
SILTY
W/S~
Very Moist, Dense
20.0'TD
20.O'TD
These logs represent subsurface sol1
conditions within Lots 4 and 5, Bl~k 1,
Valhalla Subdivision, Anchorage,
t'atc: 1"=3'
SANITARY S?.~;ER TEST
LOG OF TEST HOnF~
DA~! ~¢I F, SE
ANCIIORAGE, ~SI~
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
[] NEW
[~UPGRADE
DISTANCE TO:
Manufacturer '
I DISTANCETO' Well
Manufacturer
Type of crib
NO. OF BEDROOMS
Material
Nearest lot line
Total length of lines Trench width inches
Material beneath tile
inches
Depth
Crib depth Total effective absorption
Liquid depth
PERMIT NO.
Liquid capacity in 9aliens
Foundation PERMIT NO.
Nearest lot line
8uildin§ foundation
OTHER
c
Driller Distance to lot line
Sewer line
SOl L TEST RA,TING
UI?
INSTALLER
I
Septic tank
APPROVED ~ DATE
Distance between lines
Total effective absorption area
PERMIT NO.
area
LEGAL
72-013 (Rev. 3/78)
Department
825
MUNICIPALITY OF ANCHORAGE
Health and Environmental rotection
L Street, Anchorage, AK. .,o01
Legal Description: l- ~ L~
Type of Soil Absorption System Is:
Trench: Drainfield:
Maximum Number of Bedrooms:
264-4720
* * * HANDWRITTEN PERMIT * * *
W~P_Js-~R-ON-SITE SEWER PERMIT
Phone Number: ~-~
Lot Size:
S~d: ~ __ Holding Tank Soil Rating(sq.ft/br)
DEPTH
The Required Size of the Soil Absorption System Is:
LENGTH . /. GRAVEL DEPTH WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS * *
Permit applicant has the responsibility to inform this dJpartment during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * *
I certify that:
(1) I a/n familiar with the requirements for on-site sewers and welis as
set forth by the Municipality of Anchorage.
I will install the system in accordance with codes.
(2)
(3)
Signe~:
I understand that the on-site
the residence is remodeled to
Applicant
sewer system may require enlargement
include more that 3~bedrooms.
Issued by: ~
if
SWP/024(1/81)
,Permit ~: 821062
January 31, ].983
TO: Perrait Applicant
Subject: Lot 4 B].ock 1 Valhalla Subdivision
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982o
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 needs to be sent
to this department for documentation of the installation
date ahd to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please ]lave them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4'720.
Sincerely)
Robert C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
swP/0 5 7
Permit
Applicant:
Location:~.~4.~.
Legal Description:
Type of Soil Absorption System
Trench: Drainfield:
Maximum N~ber of Bedrooms:
MUNICIPALITY OF ANCHORAGE
Department ~ Health and Environmenta?
825 = Street, Anchorage, AK.
264-4720
* ~ ~ HANDWRITTEN PERMIT * *
~rot ect ion~~
~9501 /-~-W/za~ ,
ON-SITE SEWER PERMIT
Mailing Address:
Phone Number: ~P~-
Lot Size:
S~pa~3e-~l /~, Holding Tank: Soil Rating(sq.ft/br)
DEPTH
The Required Size of the Soi~ Absorption System ~,:
~ . ,_~,~-T-H . G-R~-L--~E-P-'FH - W-I-DTH -- .
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = ~-%~F,$~/~, ,GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and a~proval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a conm~unity sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 8 2 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more t~ 3 bedroom~
Signe~, ~.,~/' ~F_~/~/~_--~.-~ Issued by:~(.~~////-~
Applicant
SWP/024(1/81)
~Permit #: 810909
January 31, 1983
TO: Permit Applicant
Subject: Lot 4 Block 1 Valhalla Subdivision
A permit issued by this deparh~ent for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
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 needs to be sent
to this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerely
Rober2 C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
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TED FORSI & ASSOCIATEg, ,NC.
124 East Seventh Ave. P.O. Box 2470
Anchorage, AK 99501 Soldotna, AK 99669
(907) 274-9517
(907) 262-5531
L"~, ~.,~"~'~.;~,~ T"~~
/~-~1/~/1( ~'t,~./ / ,. .~e /"
Date
Subject
LETTER
.MUNICIPALitY OF ANCHORAGE
DEPT. OF H[!iLTH
ENVIRONMENTAL
~JC','l~ ~ 0 1981
0
RECEIVED
[] Please reply [] No reply necessary
SIGNED
Ted Forsi and Associates, Inc.
124 East Seventh Avenue * Anchorage, Alaska 99501 · (907) 274-9517
P.O. Box 2470 · Soldotna, Alaska 99669 · (907) 262-5531
Mr. Les Buchholz
Senior Environmental Specialist
Department of Health & Environmental
825 L Street
Anchorage, Alaska 99501
November 5, 1981
Protection
RECEIVED
Subject: Lot 4, Block 1, Valhalla Subdivision, Mound Design
Dear Mr. Buchholz:
In response to your letter of November 2, 1981, we would like to answer
the seven points you raised.
(1) The water table depth as measured on 10/21/81 was 91.80'
assuming a first floor elevation of 100.00'. The ground level by the
back of the house measured 98' so the groundwater table is approximately
5-6 feet below ground level at the proposed mound location.
(2) The backyard gradually slopes away from the house, the highest
ground above the groundwater table. The distribution pipe is located 5'
from the edge of the mound and another 15' horizotally to the foot-
ings. If your department feels this is not enough separation the mound
could be located further away from the house.
(3) The absorption area should be constructed 4' above the ground
water table.
(4) The septic tank area has
calculation.
(5) Attached are the mound sand gradation
dimensions.
(6) Mound dimensions are attached.
(7) The sewer rock trench has been eliminated.
After your review and approval
price quotas from a Contractor.
feel free to contact this office.
cc Dr. Scott Holderness
been subtracted form the mound area
classification and
of the attached drawings we will get If there are any further questions,
.~
~'Oohn T. Love[t, P.E.
C~vi~ Eng~nee~
Mound System for Wastewater Disposal
System for Lot-4, Block 1, Valhalla Subdivision
Construction gpecifications
2.
3.
4.
Scrape & ren~ve top 6"-12" of soil and sod from motmd area 10' ',,ide
x 56' long behind house 50'
Place 2' lift of iridium sand (0.01" - 0.02") as nmund tYase (2' Il. x
10' W. x 56') = 40 cubic yards
Place 10" lift of sewer rock and 4"~ perforated pipe 10" [Ix ~,' W x
56' L = 10 cubic yards.
Construct 4"~ perforated pipe 1' below surface and cover with
thick la~er of Dow C~emical Co. Strofoam Iii "Blue Board" ]~}ard stock
insulation
Install lift station equal to tlydro-nmtic SPA 25A ]'/4 lip t~mp with
36"~ x 42" deep fiberglass basin with cover 120 vo]ts/].~ insulated
with 2" boardstock iusulation or p~,.~p equal to Pennbirthy ~m~p with
mercury ~¥itch available fro~ Dice Pump Supply
Construct 1 z? ~ galvanized iron pipe. discharge l~ne from lift
station to perforated pipe wrapped '-ith heat tape 1 "'att/ft. and
insulated with Neoprene pipe insulation 20' L of 1 1/~, ~ pipe
Mound syst¢~n of sand & gravel, naterial covered with dirt, ,soil, and
excavated haaterials to be graded by contractor and landscal~d aud
seeded by owner
~ack roof line of house to have gutters installed and downspouts
directed away fr~n mound system by owner
MUNICIPALITY OF ANCHORAGE
NO'v' 1 8
RECEIVED
Morned System Imt .4, Block 1
Valhalla SubdivJ.sion
Cost Esti~mtes
1. Lift Station - $ 1,000.00 Dice Pump Supp].y 277-4313
Pump, ~vitches, Basin/Lid
2" Board Stock insulation - $17.50/ 2" x 2' x S' sheet
21 sheets for nmm~d + 4 sheets lift station
25 x $17.50 = $ 437.50
3. 40 c~ic yards sand fr~n Anchorage Sand and Gravel from their Sand
Lake Pit - '-mn't be open until April 19~2. Talkcd to Nita 344-
3327: cost $100/10 cubic yards truck load delivered to Shenandoah
Drive.
4 truck loads = $ 400.00
4. 1 load se-~r rock = $ 100.00
5. 4 loads top soil = $ 300.00
Miscellaneous - 20' 1 1~'
z ~ pipe, insulation, heat tape, electric
cord to house plug in - $ 300.00
I_ABOR AND EQUII~ENT:
F~lt~ipment:
l~abor:
3 men
Backhoe
1 bacld~oe/loader with ol~rator - 3 days
1. ~or~r~n
2. Laborer
3. Plamber/Electrician (to connect lift station up)
3 days @ $35/hr = $ 2,520.00
24 honrs ~ $50/hr = 1,200.00
3,720.00
Total Cost:
20% Profit, Overhead and Contingencies:
1. 1,000.00
2. 437.50
3. 400.00
4. 100.00
5. 300.00
6. 300.00
7. 3,720.00
6,257.50
1,251.50
GRAND TC/£AL: $7,509.00
TED FORSI & ASSOCL '-'S, INC.
124 East 7th
ANCHORAGE, ALASKA 99501
.:cy£5/t'/ V
CHECKED BY DATE
SCALE_
JOB
TED FORSI & ^SSOCIA' 3, INC.
124 East 7th
ANCHORAGE, ALASKA 99501
SHEET NO.. Z- ~/~ - ~"~ OF
CALCULATED BY ~2'-/~ DATE
CHECKED BY DATE
SCALE
~ ~ ~ ;~ _.
TED FORSI & ASSOCI/ ~.S, INC.
124 East 7th
ANCHORAGE. ALASKA 99501
SCALE__
TED FORSI & ASSOCIA' ~, INC.
124 East 7th
ANCHORAGE, ALASKA 99501
CHECKED BY DATE
SCALE
I j I I i : Ii ~ I [ I ~
][lll ] il ~' ~ lll;lll[~1 I lli' ll illll ]i ]ll{[ ll~[ I I' ~[1
~ I I I I....
, 2,1 "1 " 'SI'I/~ E ~
,r~,N (.I IOI1AG[:, A I./\. I4A ..J,.O,
(007) 2(i4 411 ~
November 23, 1981
Cathy Krupa
% Century 21 Heritage Homes
207 East Northern Lights Boulevard
Anchorage, Alaska 99503
Subject: Lot 4 Block 1 Valhalla Subdivision
(William Scott Holderness Property)
The residence, as a result of resale, was evaluated by the
Department of Health and Environmental Protection regarding
on-site sewer and water facilities.
The results of this evaluation was an engineer's report
(Ted Forsi & Associates) which stated inadequacy [)er
National Standards and it is, in fact, a sewer system which
overflowed onto the surface of the ground. The Department of
Health and Environmental Protection has three(3) ordinances
that sewage on the ground surface is a health hazard and a
criminal violation.
The Department subsequently requested the sewer system upgraded
to resolve the overflow problem and gain a health authority
approval. The sequence of events from this point is by
specific occassion as follows~
(1)
The department stipulated that a health authority approval
would be granted conditJonal].y provided an upgrade was
assured to Municipality of Anchorage standards.b~~9 ,~-zff-~z-
(2)
An upgrade of the sewer was initiated to install additional
sewage leach area to specifications of a Municipality of
Anchorage permit and in compliance with the Municipal health
ordinances.
(3)
During the preliminary excavation work to upgrade the
sewer, ground water conditions were noted which did not
originally exist during the o[iginal installation.
TED FORSI & ASSOC~ ES, INC.
124 East 7th
ANCHORAGE, ALASKA 99501
SCALE
~ ~,,,ii,i i
TED FORSI & ASSOCIP ~S, INC.
124 East 7th
ANCHORAGE, ALASKA 99501
CALCULATED BY ~ -- DATE
CHECKED BY- DATE
SCALE.
Cathy Krupa
November 23, 1981
Page Two
(4)
The Municipality of Anchorage ordinances do not allow
sewage disposal in ground water conditions evident
during the attempted upgrade. The Municipality had
issued an upgrade permit with specific data, however,
Jf current conditions at the site are not as represented
on the original data; due to r~sing ground water or change
in ground strata., the installation must be revised to meet
Municipality of Anchorage ordinances.
To summarize, the conditions of the upgrade were based upon
original soil engineering data utilized to install the original
sewer system. Unfortunately, upgrading of the system encountered
different conditions which disallowed the proposed upgrade
specifications. Changing soil and water table conditions are
always a risk and, in this case, impacted a sales/escrow agreement
between owner/seller. An upgrade is possible, however, at greater
expense due to a more sophisticated design requirement. The
existing on-site sewer system is not approved for continual use.
The Municipality of Anchorage ordinances and permits provide for
approved design and operation. Since the Municipality of Anchorage
ordinances address seasonal high water tables, which has been
established, this department cannot allow any other type of
installation at a later date that would infringe on a recorded
high water table since reocccurrence is possible.
An interim measure would be to plug the septic tank outlet, and
guarantee pumping until an upgrade is completed. The problem is
pumping frequency and costs.
The system is inadequate and overflows at 1 - 2 g.p.m. ].oading
rate, it is not operating to National Standards of occupancy as
delineated in the engineers adequacy report and is in violation
of the Municipality of Anchorage ordinances.
I hope this specifically answers your phone
If there are any further questions, please
at 264-4720.
inquiry and request.
call this office
Sincerely,
Les N. Buchholz, R.S.
Senior Environmental
LNB/ljw
Specialist
enc].osure
C,d P'
825 "1 "S'i
ANCtlOIIAGE, Al ASI<A 99501
(907} 264-4111
November 19, 1981
Ted Porsi & Associates, Inc.
124 East 7th Avenue
Anchorage, Alaska 9950].
Attention: John T. Lovett
Subject: Lot 4 Block 1 Valhalla
The proposed mound design, dated
as an upgrade design
The existing upgrade
installation must be
firm.
If there are any further
at 264-4720.
Sincerely,
Subdivision
November 16, 1981, utilized
for the subject lot is approved.
permit remains in effect. The sewer
inspected and as-bui].ts by the designing
questions, please call Lhis office
Les N. Buchholz, R.S.
Senior Environmental
LNB/ljw
Specialist
;I?5 "I " S] Rf l [
(907) 264 4 I / 'i
November 2,
Ted Forsi & Associates, Inc.
124 East 7th Avenue
Anchorage, Alaska 99501
Attention: John T. Lovett
Subject: Lot 4 Block 1 Valhalla Subdivision
Mound Design Review
(1) Water table depth aL installation site? Standing water
on the ground in the crawl space.
(2)
Proposal is thirteen(13) feet from the house foundation.
What about sewage movement 'to the craw], space floor, which
is lower elevation than absorption area.
(3) The absorption area must be four(4) feet above the ground
water table.
(4)
The absorption mound is over the 'tank. Has the area omitted
for the tank been compensated for?
(5) Mound material classification? Mound length?
(6)
Mound dimensions shou].d be three(3) feet on each side of
gravel distribution bed and then 3.1 slope ratio is
initiated. The base area of the mound should be .8 gpd/ft2.
(7)
The three(3) foot width and four(4) foot depth trench filled
with sewer rock under the mound is not requlred and does not
provide four(4) foot of "sand type" filtration prior to a
water table.
If there are any further questions, please ca].], this office
at 264-4720.
Sincerely,
Les N. Buchhotz, R.S.
Senior Environmental Specialist
enc.
TED FORSI & ASSOC[ £S, INC.
124 East 7th
ANCHORAGE, ALASKA 99501
CHECKED BY - DATE
SCALE
... ~ "'~ :..~ ~ ~ .. .
.~ ..~
rED FORSI & ASSOC. ES, INC.
124 East 7th
ANCHORAGE, ALASKA 99501
CHECKED DY DATE
SCALE
TED FORSI & ASSOC' 'ES, INC.
124 East 7th
ANCHORAGE, ALASKA 99501
SHEET NO / -
CHECKED Ely. DATE ....
SCALE
TED FORSI & ASSOCIATES, ..~C.
124 East Seventh Ave. P.O. Box 2470
Anchorage, AK 99501 Soldotna, Al( 99669
(907) 274-9517 (907) 262-553!
Date //~L?~'~/
Subject ~.x//_/'/~/~'~:~'/
~'- .,,L ~'~- /
LETTER
[~ Please reply j~ No reply necessary
fORM 156-2 Available Irom ~lrJc, Groton, Mess. 01,450
81GNEO
MUNICIPALITY OF ANCHORAG~
DI~PT, OF IIEALTil &
ENVIRONMENTAL p;,OT~CTION
NOV ~. ~ 1981
RECEIVED
Ted Forsi and Associates, Inc.
124 East Seventh Avenue · Anchorage, Alaska 99501 · (907) 274-9517
P.O. Box 2470 · Soldotna, Alaska 99669 * (907) 262-6531
August 28, 1981
Dr. Scott Holderness
207 E. Nothern Lights Blvd.
Anchorage, Alaska 99501
Re: Adequacy test in Lot 4, Block 1, Valhalla
Subdivision SW1/4 Section 22, TI2N, R3W, S.M.
Dear Dr. Holderness:
On August 27, 1981 an adequacy test of your on-site sewage disposal
system was made. Your system, built in 1977, consists of a 1,000 gallon
septic tank followed by 38 feet of perforated drainfield. The ground
around the drainfield had been soaked prior to the test. A flow rate of
1-2 gallons per minute was placed down the cleanout at the head of the
drainfield by the small greenhouse. The level of water at the other end
of the drainfield ~,mme~,iat~9~y_,_£~e~,~ waterbe~,_~c.ij~g~£o~£.h~
This drainfield is~JlOJL~_~q~u~SgX2~%h~5~j,~. We
recommend that an entirely new dra~nfield be installed to thy ~6~thwest
of the existing system. Before this can be done a new upgrade permit
must be obtained from the Anchorage Health and Environmental Protection
Department. This permit will cost $20.00 and will show the minimum
demensions and design criteria for construction of a new drainfield.
After reviewing R & M soils report done on February 23, 1977 we would
recommend a new trench type drainfield with a mimimum absorption area of
525 square feet. This is based on a soils rating of 175 square feet per
bedroom and a three bedroom house.
If you have any questions, or if we can be of further service to you,
please feel free to us.
Sincerely,
TED FORSI & ASSOCIATES
John T. Lovett
Civil Engineer
.n ineerin t · Planning
JOB
TED FORSI & ASSOClk -S, INC.
~.24 East 7th
ANCHORAGE, ALASKA 99501
SHEET NO,. OF
CHECKED BY DATE
SCALE
o o
o .<t
o
9
CERTIFICATE of SURVEY
OWNER OF RECORD
I',ia me City State
hareby certify that the following described property ha* been lurve.'ld by me or under my *uper-
and that improvement* situated ther*on do not *ncroach on adiacent property~ that Jmprowm*nt~ ~
odjacent propertydo not encroach on the ~urveyed pr~i~e~ and that ther, ar, no power llne~ tran*mi~i~..
or other vi*ible ~a~ements or rJghtl-of-way except al Ihown hereon~
-LFGEND'
B.L.M. Brasl Cap Monument Fnd.
I~a~ Cap Monument, Sel__,Fnd.~
Iron Pipe r
~/1" ~ 30" Rebar~ Sel__,Fnd.~
Survey Hub & Tack~Set__~Fn~.~
SU BDIVIS ION _ %,'ALH AL~-,~-
'": ,~-.h.-~Z.~-i RECORDING PRECINCT,ALASKA
FOR
UNWIN.SCHEBEN,,KORYNTA
CONSULTING ENGINEERS ~nd SURVEYORS 103 E 261hAve Anchm-age, Ala~a 99503
DRAWN~._~z,'~' 'l SCALE I"~-/--JO' I DATE --7~'/~ 77 J w.o.-7-7~H J F.B. ~l I ORID E75Co
T'T'PE OF: :50:[L. FIE:':SOF~!E:TION S"r'STL-'.'H :IS: "FF."'.IEi",ICH
IflFI::'::IHLIH NUi"IBEI:~'. (::Il:: IF.:IEDFb::~OHtF:; =
THE I:~:IEC!U I F?.IE[:' 5;i ZE OF' 'f'HE 2;0 ):1... FIBSORPT I Ol",l S'¢STIEH I S:
E:::" 117YS: IF;:" '-If" If.il ......
'I"HE LEI",IGTH [::,IHEN$]ZON ]:S THE L_.ENC~TH ,~IN F['ZEI"::, OF 1'HE "I"I:~'.IEI'4i:;I"I OR
THE [.':'EPTFI OF:' FI 'TRENCH OF~'. PIT :[:~; THE D ZSTFII'4CE BE"I"NE:EI",I THE. SUI:;~rF'F]E:E O1:-' THE:
(~i[~'.()lJ['.,ll;) I:.:1['.,1[.';~ THE BOTTOH OF THE E',:'.,'CR',,,'RTZON ,:::[I'.,I FEET).
TI'"IIER[:.'i: IS NO '.2,1ET I.,.I:[DTH F'OF;~'. TF.'![.::NCHE'.:~;.
THE GI;~:R',,,'I:EL [.':,I~:PTH ]::(i; THE HIN]:HUH I)EPTH O1:: GI:~'.FI'¢I~:%.. [~E:'Tt.,.IEEN TI"~E OUTF'FIL.[. PII::'E
RI",II'::, THE BO']"']"Ol'"l OF THE E:,:',CFI',,,'R-I":[OI",I ,:::I:N I::'EET::,.
E:F'IE:I.(F ILL. ]: NG OF RN"r' S'-r".E;TIEH I.,I :[ THOUT F' ]: 1"4F¢.... I N"51::'EF.C"I' :1: ON RNt::' RI::'PI~'.Ok,'RI... E:'¢ 'TH I S
I:.':'EF'FII:~'.TFIIEN-F I.']:[L.L E:E: SUB,:rEE:'F "f'O PF'.OSEE:UTION.
H]:N]:HLIH [::,I:.Z.;'I'F~I'.,ICI~: BI.C'I"I4[.ZIEI'.~ FI I.,.IELL. RI'.,ID RNY ON--.tlil;:[TE SEI.,.II::IGE DI2;F'OSFII._ S;'.r".E;TIEH IS
:~.Ei(1) FrE~ET F::CIF~: F:I PRt',/FITIE !-,.IELI_. i:'.)~1~ ;~fi~l!:Z1 F"[CET FOR FI F'I...If31....IC I.,IIELL.
14EI._I... I_..O(:~i':'~; FII:;;'.[E I;?EC!tJII';..'I~:I:::' RND I'"ll..J'.':~;'l' E:E RETURI",tEI) ~1"£) "[t~[[:~: DEF'F:II;?.THIEI",IT I,.I];THIN :i[:(I
L-iF THE I.,.IE:I.J.... COr"IF'LIETZON.
'.ii;F'IEE::[I::ICI::FI']:E~I'.,IE; f:lN[:, E:ONS"I"I';.'.UCT]:E~N [.) ]: RGfRI:;IP'I2.:, RRE RVFI:[I._I::IBLE TCI :[i'4Sl. Jl:~Ei:
]: I',IS"['FILL FIT I ON.
I CEle.'l'IF'.r' 'TI-'IR'T'
::[.: I FIi','I I::'FIH:[LIFt[~: I.qITH THE REI;!I.J]:I:~:IEHIENT2;
FORI"I'I E:'T' THE P]Lff',IICtPIal....IT'T' OF FINCHOI:;rI:~E4E.
2: I 1.4II_L :I:NL:.;'I-I:'IL.L. TI-lIE '.E;'.r':F:71'EM IN F:ICCCq'~'.I:)F:INC[E P.II"FH THE CO[:,E~;.
:~:: I UND[.:.'I:;;%"I"I::;I'q:;, THFIT 'THIE OI'.,I.-%]:'fE '.SEI.,.IER .':_i"r'S'f'El'"l HR"r' F:EC!UI,r~:E IENLFII:~,'.EiEf'IENT IF' THE
I:~:IEE;:[E:,IENC:E ]:E~CII:C:,E:LI!EI:::, TCI
F~F'PI... I CFINT [:,RN
~:a GREA
,~R ANCHORAGE AREA BOR~.~GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC T A~,~
DISTANCE /~' D~: ~"~° ¢'g-~- ~//)~ )-~ ~. NUMBER OF
FROM WELL /(';'¢~) i MANUFACTURERc) ~#~,2.~ MATERIAL COMPARTMENTS
INSIDE LENGTH ~-- INSIDE WIDTH 2:T-~ LIQUID DEPTH LIQUID CAPACITY_ GALLONS.
1 /~ ~_,~..c/~
'T-I ~D RA-I-N-FI-E~LD
DISTANCE FROM WELL
NUMBER OF LINES
/ FOUNDATiON_~..~g.'~ ('
DISTANCE BETWEEN LINES
AREA ~(? ~ SQ. FT. LENGTH OF EACH LINE
ABSORPTION
DEPTH OF FILTER
OEPTH: TOPOFTILE TO PINIBH GRADE '~_ ~' MATErnAL BENEATH TILE27~
IN. ABOVE TILE ~' IN.
WE,.:
TYPE_
· ' ~'--/'")~5 / ~'~? .__DEPTH
CONSTRUCTION _ ~ / '~ ." I ?
DISTANCE FROM:
BUILDING NEAREST
FOUNDATION__ LOT LINE
NEAREST (, SEPTIC , [ SEEPAGE
SEWER LINE~~'~ TANK~'~'~, SYSTEM
CESSPOOL
APPROVED
OTHER SOURCES
DISAPPROVED
SEWER LINE DEPTH:.
DIAGRAM OF SYSTEM
Form LQ-Q32
13'W.D.
TN-1
2-22-77
0,0'
ORGANIC ~ATERIAL
Dark Drown, Very ~Ioist
3o0I
SILT W/SO~E SAND
Moist, Occasional Cobble
5.0'
SANDY SILT
W/TRACE GRAVEL
Moist, Medium Dense
11.0'
SILTY SAND
W/TRACE GRAVEL
Moist, Medium Dense
20.0'TD
TH-2
2-22-77
ORGANIC ~TERIAL
Dark Brown, ~4oist
SANDY SILT
Brown, Moist
3.0~
SILTY SAND
W/TRACE GRAVEL
Moist;
Boulder at 9[
10.0'
SILTY SAND
W/SOME GRAVEL
Very Moist, Dense
20.0'TD
These logs represent subsurface soil
conditions within Lots 4 and 5, Block 1,
Valhalla subdivision, Anchorage, Alaska
: JMA
~ 2-23-77
SANITARY S~';ER TEST HOLES
LOG OF TEST HOLES
DA~ WIESE
ANCHORAGE, ALASKA
~ 2736
JLow o. A-02
February 23, 1977 R & M No. 751111
Mr. Dan Wiese
SRA Box 1542W
Anchorage, Alaska
99507
Test Hole and Soil Log Report for Sanitary System
Lots 4 and 5, Block 1, Valhalla Subdivision, SW¼, Section 22,
T12N, R3W, S.M. Anchorage, Alaska
Dear Mr. Wiese:
We are submitting herewith the test boring results and our comments
regarding soil conditions encountered at the subject site. This
investigation was performed in accordance with your request of
February 17, 1977 and those procedures outlined in a letter dated
July 15, 1975, by Mr. Rolf Stickland of the Municipality of Anchorage,
Department of Envirornnental Quality.
A single test hole was bored on each lot within the subject area for
the purpose of defining general subsurface soil conditions for the
proposed sanitary systems. Excavation was accomplished with an auger
type drilling rig and each test hole was extended to a total depth
of 20 feet below ground surface. The final logs prepared for the
test holes have been included in Drawing A-02.
Groundwater was encountered in each test hole while drilling. In
Test Hole 1, groundwater was encountered at 13 feet. In Test Hole 2,
groundwater was encountered at 14 feet below ground surface.
A percolation test was performed from a depth indicated and reflects
average infiltration from that depth to the bottom of the hole.
We appreciate being given this opportunity to be of service to you.
Should you have any questions with regard to the above, please do not
hesitate to contact us.
Very truly yours,
R & M CONSULTANTS, INC.
James W. Rooney
Vice President
JWR/pe
xc: Municipality of Anchorage
TH-1
PERCOLATION TEST
Lot 4, Block 1, Valhalla Subdivision
Anchorage, Alaska
R & M No. 751111
ELAPSED
TIME TIME INCHES
3:16 0 10.00
3:17 1 11.25
3:18 2 12.00
3:19 3 12.50
3:20 4 12.75
3:21 5 13.0
3:22 6 13.125
3:23 7 13.25
3:24 8 13.375
3:25 9 13.50
3:26 10 13.75
3:31 15 14.50
3:36 20 15~00
3:41 25 15.50
3:56 40 17;25
4:06 50 18.25
4:16 60 19.&25
DROP IN
INCHES
0.00
1.25
2.00
2.50
2.75
3.00
3.125
3.25
3.375
3.50
3.75
4.50
5.00
5.50
.... ~_125
7.25
8.25
9.125
6.58 Minutes Per Inch
LOT 6
LOT 5
TH-2
LOT 4
o(.\ v
¥
LOT 2
LOT 1
/\
HUFF}~N ROAD
Test Bole locations are approximate
and have not been located by
survey methods.
Location of Test Holes in
Lots 4 and 5, Block 1,
Valhalla Subdivision,
Anchorage, Alaska
KD: J[~
A!E: 2-23-77
[ SANITARY SEWER TEST HOLE
LOCATION DIAGRAM
DAN WIESE
A[~CHORAGE, ALASKA
J (.OWO. N O.
2736
751111
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.
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions) I ~ ?...7c~ ~. I~.~ ~,~-~,~. F~ ~-~
Property owner
Mailing address
Day phone "~ q~ - ~
Lending agency
Mailing address
Agent
Address
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-
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.
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 inves.ti_gation 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'-'"C",'~N~¢~- ~c~. ~ Phone
Address _'~'~, c~.~-,c> ~ / '-I~c ~.~
Engineer's signature- ~ ~ Date
DHHS SIGNATURE
Approved for -~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Date /~.~-,~ 2
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 enginser 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.
72-025 (Rev. 1/91) ~ack MOA ~21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICinG tiME D
Environmental Services Division
825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
SEP 24 1996
Mueicipality of Anchorage
Health Authority Approval Checklist Oept, Health & Human Services
Legal Descril)tion: /.
Parcel I.D.:
A. WELL DATA
Well type ~ If A, B. or C. attach ADEC letter. ADEC water system number
Log prcseut (Y/N) ,/L) Date completed
Total depth o~b..c~,coeo Cased to
Casing height (above grouod) /&"
Sanitary seal (Y/N)
Wires properly protected (Y/N)
FROM WELL LOG
AT INSPECTION
Date of test
Static water level
Well productioe ~ g.p.m. /~/' ~ g.p.m.
WATER SAMPLE RESULTS:
Coliform ~ O ~ Nitrate ~, .X OIher bacteria
Date of somple: q'/I.~/~/~'e/,~;/,~'~:. Collected by: --q - la ,~::>/Iv.4J.~¢./,J ~- x~. ~.,
B. :ffiglrl~/ItOLDING TANK DATA
Date installed /o/2tl/oj 3 Trod4 size 2~>~'e::,O Number of Compartments I Cleanouts (Y/N) ~
Foundation cleanout (Y/N) '~ Depression (Y/N) t,q High water alarm (Y/N)
Date of Pumping ~/I,~J°J[:, Pumper
C. ABSORPTION FIELD DATA
~sh~........~ Soil rating (g.p.d./ft2 or ft2/bdr,n) System type
Leogth 3tC/dtlL Gravel thickness below pipe
Date of adequacy test ~tt'E(PassfFa-/~ FOl', bedrooms
~~~i ~i ~ )~ Mo iiltll tsl s( Iyat/~i: Absi~fil,°griltfcl;e
. Size in gallons
Manhole/Access (Y/N) ~ at*exrffCfii
High w~ / r ~ *D,atum-~...
C/yz4es'Ihsted
E. SEPARATION DISTANCES
"Pump oft" level at*
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank ou lot / ~. q ~
; On adjacent lots
Absorption field on lot
; On adjacent lots
Public sewer main lc,O'/-
Public sewer nmnhole/cleanout e' r~o+
Sewer/septic service linc
Lift stution
SEPARATION DISTANCES FROM 8t~i~/HOLDING TANK ON LOT TO:
Building foundatiou / ~ '~ Property line / S fi' Absorption field
Water mairdservice line ~ &-'" Surface water/drainage /e~o'/-' . Wells on adjacent lots / cga~ '~'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundution
Surface water
, Water main/service line_g._..~-~
~icle storage area
Wells on adjacent lots Property line
F. ENGINEER'S CERTIFICATION
I certify that I have determined thrufield inspections and review o
in conformance with MOA HA.4 guiclelines in effect on this date.
Sigl~"~~
Eugineer's Name
HAA Fee $
Date of Paymeut o
Rev, 8/95 OSS: haa,wk.doc
Waiver Fee $
Date of Payment
Receipt Number
B9%18796 !6:2~ CT&E ESI AHCHORAGE ~ 90? ~72 e,2~.~ No. 265 Q02
CT&E Environmental Services Inc.
Laboratow Division
Drinking Water Analysis Report for Total Coliform Bacteria 2oo w. ~o.,r 0Hve
Anohoeage. AK 99}~'18,1606
REA,D IN,.~T. RECTION,.q ON REVER.,.qE SIDE BEFO.R~. COLLECTING SA34'.PLE Tel: (907) 582-2343
Fax: {907) 561-5301
........ M'L'ST ~ COMPLETED BY WATER SUPPLIER
PUBLIC WATER SYSTEM I,D. # J--I '--I J J I I
PRIVATE WATER SYSTEM
JJ
..... ff~ .....
Month Day
$~PLE ~PE:
Routine ~
Repeat Sample (for routine sample O
with lab re[ no, )
Special PurpO$~
SAMlaLE LOCATION
Comment~:
Year
Treated Wat,r
Untreated Water
Time Collected
Collected By
TO BE C~4PL,ETED BY L&BOP,.A'~'ORY
,~$i$ aho~$ this Water S~PL~ to
5atiafactoD'
Uasatisfacto~
Sample ov~r 30 hours old, r~sults may
be unrdlable
SampD too long in transit; sample should
not be over 48 hours old at examination
t0 indicate reliable results. Please send
Date Received - · -
Time Received , {.
/
. .
Analysis B~,an ~[~
Analytical Method~ ~ Mombran,
b~O.MUG
Numb:r of colonies/100 mi,
Lab Rat. No, Result* Analyst
~ant t0 A.D.E.C. Anch Fb~ Jun
Faxed
Client notified of urlsatJsfaeto~ results:
Phoned Spoke with Faxod
Date: Time:
BACTERiOLOGICAL WATER ANALYSIS RECORD
MMO.MUG Result: Total Coliform , ~", Colt
Fecal Coliform Canflr~ntign . ..
Final Membrane FIR
g~poned By Date Time .,, hrs
~I~4 CT~E ESI ~NCHOR~GE ~ ~07 2?2 82~ N0,9~0
CT&E Environmentat~rvlces Inc.
Laboratory Division
Drinking Water Analysis Report for Total Coli£orm Bacteria 20o w, Po.ar omc
Anohoraga. AK $951 ~-1 605
Ri.AD [/VSTRUCTIO;V$ ON R£V£R3E'~YlI)E J~I~FOR,.S CO~LECJ'I~VG,.~A/I,IPLE Tel: 1907) S62.2343
T
MUS BE COMPLETED BY WATI~I~ SUPPL ER
PUBLIC WATER SYSTEM I.B,
PRIVATE WATER
~qend R#$Mt$ El ~end lnt'olea
"qL~ Send lnvo/ce
Month Day
~, SAMPLE TYPE:
Routine
~ ~ Rape,at Sample (fOr routine sample
~. with lab ref, no. ~. )
D Special Purpose
SAMPLE LOCATION
Year
Treated Water
Untreated Water
Time Collected
Collected By
Fax: (9071 561.5301
TO BE COMPLETED BY LABORATORY
SiS shows Ibis Wa~er SAMPLE to be:
aris factory
tJnsausfe¢ ory
Sample over ~0 ho~rs old, resuh~ may
b~ unreliable
Ssmpl* too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable tesulB. Please send
new sample vi~ ~peeial doliFer~mail.
A~alysis Began [ 6,,~
Analytical Method; ~'-Membrene Fthcr O MMO-MUG
Number of colonies/100 ml,
Lab Ref. No, Result* An,alyst
S~nl lo A,D.g,~. Aneh Fb~ Jun ~
foxed
Date: Timer
Client notified Of unsafisfi~cto~y results:
Phoned Spokl with
Dala; ,, T mc;
BACTERIOLOGICAL WATER .~dN'ALYSIS RECORD
MMO-MUG Result: Total Collier m ..... £,C011__
Membrane Filter: Direct Cou~t (~ ColonlesllO0 mi
Verification: LTB .... _ IIGB . . COLIFIRM ....
Fecal Coliform Conl~rmafion __ _
Final Membrane Filter Res?$ ~ .... Coliform/J00 mi
Reported By ~~' Time ~
Foxed
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. # ~/5'~/~-~'> ~
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner /~.f,~z~f-.-/'" /,t~y'~_~,,~¢-~ Day phone
Mailing address /~,=' ~,,,.~.~.~¢~.,=~./',,~,./~. /z,~" ~,4,-v'~/~ ,¢-/<
Lending agency Day phone
Mailing address
Agent Day phone
Address
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Unless otherwise requested, HAA will be held for pickup.
NOTE:
Individual well
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
72-025 (Rev, 1/91) Fronl MOA
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
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 an¢/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 /~/)ET~O~J /-~(.;~tJS.-~'-~4~/(~ Phone
Address
Engineer's signature ~/~----' ~-------~~ Date
DHHS SIGNATURE
YApproved for '~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
By:
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 DH HS 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.
72-025 (Rev, 1191) Back MOA #21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
Parcel I.D.
If A, B, or C, attach ADEC letter,
A. WELL DATA
Well t y p e,/~r/~/¢''
Log present(Y/N)
Totaldepth ~
Sanitary seal(Y/N)
ADEC water system number
Date completed ?'¢,F~ l ~b~;' Driller
Casedto ~ /,/0' Casing height .,,,r'"' /.,~
wires properly protected (Y/N) T
MUNICIPALiTy OF ANCHORAGE
AT INSPECTIOJ~viRONMENTAL SF. RVICE$ D/VIS/ON
ocr
FROM WELL LOG
Date of test
Static water level
Well flow -~
Pump level "'
g.p.m.
>7.0
SEPARATION DISTANCES FROM WELL TO:
-SeCic/h~_ol.ding tank on lot '~-- //¢/
Absorption field on lot
Public sewer main > / ~1/'~'
Public sewer service line -> /
; On adjacent lots
; On adjacent lots > /~'~'
Public sewer manhole/cleanout
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Nitrate
Other bacteria
Collected by:.~
"gEP-ZI~/H O LDIN G, TANK DATA
Date installed /~'/~//~ Tank size
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping
Foundation cleanout (Y/N)
Compartments /
Depression (Y/N) ,N'/
Alarm tested (Y/N) //v
SEPARATION DISTANCES FROM-S-EC~T4C/.HOLDING. TANK TO:
Well(s) on lot ~ ~¢.-/1/~ Onadjacentlots > (f~4)~
To property line ~ /~'¢
Surface ya~er/d,~
Absorption field ,,t///~
/
Foundation ~ /'~!
Water. mei-~/service line
72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE
C. LIFT STATION /v/,C..---
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrica~
SEPARATION D~,,$n~'ANCE FROM LIFT STATION TO:
Well oj~k~ _ On adjacent lots
Manufacturer ~
Manhole/Access~
"Pump on" levelat ~~ "Pump off" level at
Cycles tested
Surface water
D. ABSORPTION FIELD DATA /,/'/~-'~""
Date installed Soil rating
LT;;~lt;bsorption area Width _,~Gca~;;;;;~ present (Y/N) T/taldepth
over~__ . Date of adequacy test
Depression
Results~,) ____~_ for
e treatment (past 12 months) (Y/N) If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO; /~//,4-----~¢~
Well on lot On adjacent lots J Property line
To building foundation .~sting or abandoned system on lot
On adjacent lots .---'"~Cutban k __ Water main/service line
Surface~l'~ Driveway, parking/vehicle storage area
.t¢~i¢i d rai n
E. ENGINEER'S CERTIFICATION
~-~'~ System type
bedrooms
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on,tt~e, date of this inspection.
HAA Fee $ *--~ (~'
Date of Payment
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
FAX: (907) 561-5301
Ordered :y : R~c~iv~2 :03/19/9:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date /'~:'¢¢ /4~//,~,2~ __
GENERAL INFORMATION
(a)
(t))
(c)
L~,,__al Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
Applicant Namev~~, ~+~uK Telephone: Home ,~ ....... Business .
Ap¢ .ntAddre s
Applicant is (check one): Lending Institution ~; Owner/builder D; Buyer~; Other D (explain);
(d) Lending Institution
Address
Telephone
(e) Real Estate Compaey and Agent
Add~ess
Telephone
(f)
Mail the HAA to tile following address;
TYPE OF RESIDENCE
Single-FamilyJ~ Multi-Family []
Number of Bedrooms -~
Other
WATER SUPPLY
Well/~ Community [] Public []
Individual
Note: II community well system, must have written conlirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite.~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to tbe legality and status.
Page 1 of 2 72 025(11/84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wasteweter 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 ~ ~'/~¢'~',~-f~-2~ Telephone PL'°¢'o¢" ~ ~ ~
Address .~~ ~Z~ ~~ ~ ~¢¢~
Engineer's Seal
Approved for (~'~rt-C-~Jbe d roo m s by/~/~ ~""~ ' ~'~'~'~-~e
Approved %/' Disapprove~L,/ Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
M .............. HEALTH AUTHORITY APPROVAL (HAA)
AN£HOR^"~,~'~IECKLIST'"': FEBRUARY 1984
DEPT. OF HEALTH & -
ENVIRONMENTAL PROTECTION
RECEIVED
Well Classification ~'//V~/~F
Well Log Present (Y/N)
Total Depth ~' · Cased to 7Z ·
Static Water Level _ ,~/~'~ //
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
If A, B, C, D.E.C. Approved (Y/N)
Date Completed ~"¢' /;¢~¢ Yield
Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
/O¢ z¢, ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot /~7~ ; On Adjoining Lots
To Nearest Public Sewer Line ~/~ To Nearest Public Sewer
Cleanout/Manhole ~/~ To Nearest Sewer Service Line On
Water Sample Collected by ~~~/~ ~ Date
Water Sample Test Results ~~ ~
Comments ~ ~ ~ ~//>~ ~
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N)
Depression over Tank (Y/N)
Size /~:2~No. of Compartments ~
Air-tight Caps (Y/N) ,,,4/~____~ Foundation Oleanout (Y/N) ~
~ Date Last Pumped ~/ 7'¢~r7]~-~'~'~'¢~
Pumping/Maintenance Contract on File (Y/N) /f'/,/""/'~ ;for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well /,¢:~ /
TO Property Line '"~ ~:-~ /
To Water Main/Service Line
Course
Comments .¢ ~/~,.~,~,'~;¢z ¢c ~.-'
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
72 026(11184)
C. ABSORPTION PfEL-D DATA
Soils Rating in Absorption Strata
Date Installed .~//~.~-
Width of Field ,~-~) /
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test _
Separation Distance from Absorption Field:
To Water-Supply Well __ /(,2~2
To Building Foundation
LOt /'~/,//"~
TO Water Main/Service Line __ ./~//.,*.'~
To Stream/Pond/Lake/or Major Drainage Course __
To Driveway, Parking Area, or Vehicle Storage Area
Comments /J'/'2 ~,~'~'~I;' ¢./~
Type of System Design
Length of Fie~.
Depth of Field _ '¢/ /
Gravel Bed Thickness "~ !
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line ~¢~)
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present) __
D. LIFT STATION
Date Installed Dimensions ~' ~/,~ ~ Z~O~
Size in Gallons /_~"'~2J~_~.,~r..~2 Manhole/Access (Y/N) _ ~ _~/ ~ ~/
"Pump On" Level at m ~ ¢ ~~ "Pump Off" Level at -- ~" ¢ ~ ~_
High Water Alarm Level at ~ ¢ ~ ~¢ ~/~ Vent (Y/N) _ ~o
Tested for _ /~ ~) Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N) _ ~
Comments ~*~ ~~_ ~¢/~ ~/¢ ~//~ ~
** Check Permitted Bedroom Rating Against HAA Request **
~i~;~;e;;° ~%AA guidelines in effect °n the date °f this inspeoti°n'
Receipt No. ~ ~¢ ~/¢
Date of Payment ~/~ ~ ¢ ¢0
Amount: $ ~ ¢ ineer's Seal
Page 2 of 2
72-028 (11/84)
r ' ' DA,,~ RECEIVED
}ATE -- DATE D A~.T~ E _
INSPECTOR INSPECTOR INSPECTeR~ ,
ENVIRONMENTAL SANITATION DIVISION AU¢ 1 9 1981
Telephone 264-4720
DI RE~TIONS: Complete all parts on page 1. Incomplete raquests will not be procassed, Please allow ten (10) days for processing,
1. ~OiPERTY OW~F ~ PHONE
PHONE
MAI.lNG ADDRESS
MAILING ADDRESS '
5. LEGAL DESC~BIPTION
STREET LOCATION '
6. TYPE OF RESIDENCE
[]~/S lNG LE FAMILY
NUMBER OF BEDROOMS
[] One [] =our [] Other
[] Two [] ~ive
[] MULTIPLE FAMILY [] Three [] Six
7.WATER~UPPLYiNDiViDUAL. 6~¢2~¢)r~ '-~2.~'. ATTACH WELL LOG, A well log is required for all wells driHed
[] COMMUNITY since June 1975. For wells drilled [~rior to that date, give well
[] PUBLIC UTI LITY depth (attach log f available.)
8. SEWAGE DISPOSAL SYSTEI~I
J~ NDIVIDUAL/ON-SITE** /~ "~ "~ YEAR ON-SITE SYSTEM WAS INSTALLED,
[] PUBLIC UTILITY
NOTE; THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE 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 UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTI LITY ~_~? ~'~ '~
Connection Verified INSTALLER
[]Septic Tank or [] Ho[ding Tank
Size: /"4~d20 If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
[] APPROVED FOR BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY
72 010 (Rev. 6/79)
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT OF '~ITI-I &
DEPARTMENT OF HEALTH & ENVIRONMENTAL~'I~,~,~'~i~I~JL0~'AL'~P'iiOTECT[O~
A,,chorage, Alaska 99501
825
L
Street-
DIRECTIONS: Complete all Darts or page 1, Incomplete reqqests will no1 be processed, Please allow ten (10) days for processing,
1. PROPERTY OWNER PHON~
MAILING ADDRESS
PROPERTY RESIDENT (1~ different from above~ I
2. LEND~I,NG INSTITUTH~I~-
4. R EA~.~O R/AG ENT
MAILING ADDRESS
PHONE
PHONE
PHONE
PHONE
§.LEGAL DESCRIPTION~
TREET LOCATION
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
~ SINGLE FAMILY ~ One ~_ Four ~ Other__
~ Two ~ Five
~ MULTIPLE FAMILY ~. Three ~ Six
7. WATER SUPPLY
~ INDIVIDUAL' ' ATTACH WELL LOG. A well Icg is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior to that dale, give well
[] PUBLIC UTI LITY depth (attach Icg if available,)
8. SEWAGE DISPOSAL SYSTEM
[~ NDIVI DUAL/ON-SITE**
If svstem is over two (2) years old an adequacy test is reouired
[] PUBLIC UTI LITY by this Depar[men[,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72~10(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR iNSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE 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 UTILITY
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. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5, COMMENTS
~/AAPPROVED FOR , -~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY (Title)
L GALD S TION
72-010 (Rev. 3/78)
~ . " ' MUNICIPALITY OF ANCHORAGE
(i"~'~-~ ~ ~EpARTM_EN OF HEALTH AND. ENVIRONMENTA
',~_~// t ("~/~ ~..~ ~ , 264-4720
Da~e 11-2-77 Wednesda~ Dake
Insp Buchholz Insp
PROTECTION
99501
November 1, 1977
Time
Date
Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: Home Federal Savings and Loan
Mailing Address: 835 D Street Phone:
Property Owner:
Mailing Address:
Daniel G. Wiese Phone: 264-6937
Star Route A Box 1542-W 99507
3. Legal Description: Lot 4 Block 1 Valhalla Subdivision
4: Single Family Residence: (x) Number of Bedrooms:
Multiple-Family Residence: ( ) Number of Bedrooms:
Three
5. Well System: Individual well (x) Community/Public System ( )
Permit # Depth .of Well 74' Well Log on File
Construction -~ Bacterial a ys'
Sewage Disposal System: On-site System (x) Public Utility ( )
Permit # Installed 1977 Installer
Septic Tank Size
Manufacturer
Absorption Area
Soils Rate
Material
7. Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
Page Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 4 Block 1 Valhalla Subdivis~oD
Comments:
Affadavit Attached: ( ) Letter Attached: ( )
Approved:
Department Worksheet:
Date:
Date:
MUNICIPALITY OF ANCHORAG~
Deparhnent of Ilealth and Environmental Protection
<~TN~:l~equest for Approval of Individual Sewer and Water Facilities
Mailing Address: Phone:
Lending Inshitution: ~~ ~~X~__~
Ileal tor/Agent:
Mailing Address:
Phone
SLngle Family Residence: (~ Number of Bedrooms:
Multiple Family Residence: { ) Number of Bedrooms:
Water Supply: * Individual Well
If IndivLdual Well, we].] depth
(~ Puhlic/CommunJty System ( )
If Community System, name of system
Sewage Disposal System: *~Dn-sJte System (~ Pnblic System
If On-site System, date of installation:
*NOTE: A well log is required en ALL wells drilled since 6/75.
**' If on-site sewer system is over two(2) years old, an adequacy
test is requJ, red by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77