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HomeMy WebLinkAboutVALHALLA BLK 2 LT 7LoT' 7 TONY KNOWLES, GOVERNOR LWPT.OF ENVRONMEN TAL CON SEftVV3'ION ANCHORAGEN'IF_STERN PUBLIC SERVICE AREA OFFICE 555 CORDOVA STREET Anchorage, AK 99501 (907) 269-7505 January 4. 1996 Mr Michael E. Anderson, P.E. Anderson Engineenng P.O. Box 240773 Anchorage, AK 99524 RE: Lot 7, Block 2 Valhalla Subdivision; On-Site Wastewater Disposal System Upgrade and Waiver of Horizontal Separation Distance. ADEC Project Nos. 9521-WW-181-352, and 9521-WV-181-447. Dear Mr. Anderson: This letter is in reference to the materials received in this office December 11, 1995, requesting operation approval for a recently constructed on-site wastewater disposal system. The Department has completed its review of the submitted materials which included an as-built plan, a completed "Certification of Construction for Domestic Wastewater Systems" and a completed on-site water and sewer certification form. Based upon this review it appears that the system was constructed substantially in accordance with the plans previously approved by this Department. Therefore. in accordance with State Wastewater Disposal Regulations (18 AAC 72.200) approval to operate this system is granted. Expansion of the above will require prior approval by this Department before construction. This approval does not imply the granting of additional authorizations nor does it obligate any state, federal. or local regulatory body to grant required authorizations. Thank you for your cooperation with this Department, if there are any further questions regarding the above please do not hesitate to call. Sincerely. Michael Lu, E.I.T. Environmental Engineer MLU/pt . Page 3 of 5 rReport for On-Site Water and Sewer System Certification Audit Stamp No. GENERAL INFORMATION _ ..._ egal Description of the I.ocation --- Lot 7 , Block 2 , Valhalla Subdivision 12200 Shiloh Road ' pplrcant 'vama Applicant Is. lCtteck onat amen Lockard (L�"111 Bank LJ 'installer JLlwnerrluiltier duress(Street or P. 0: Box) TypoIof Residence Total Na,of Bedrooms D 12200 Shiloh Road SingieFamily Mulct-t-smity t Four !y. State and :rip Conn _._ 'telephone PubbcAxonmodadOn Anchorage , AK 345-043 3 DRestaurant OLounge Dottier ti A:Jp•Ova, TO K.F 4nvnt:an: 0 Qthnr ;Ciryo Name R Aartrassi I. WATER SUPPLY SYSTEM Ow re of Water ono Containment(China aIJ that Apply) Type of Water Supply Syttem TY•eattnont of Water ICheck all that Apply) �l Veen (Drilled or Driven) 0 Surface(Identify) ❑Private �tJNone DChlorinal on J fool Cmtchmrrttt ©prlpirr. (Serves rnore than one 0 L Filtration Oh/limpid Removal Other I identify) 1t 7.--1rtOlrJrnq Yank family) ❑Othet Jru Data Is the Height 01 the Well Casing more than 12'•attave the Ground? ® Yea ❑ No Is a sanitary seal intuited on the well casings Vu yes 0 No Is t:rern»fe directed away from or around the casing with•n a radius of ID feet at the well casing+ I�3 W Yet 0 No :at.: Or .Idrt Daoth of Well IFrreti Starer Water Levee t'eet) Yield(If Available) Purno Rata Ilf Aye:lab/al ; nknown 75 ' 32 ' N/A Gal;Min N/A Del/Min salvation Dntonrei from Me Well Casing to earn of the Fottowing Soi-roes of Con:ern nntton, ,,apticr Herding Tank on Lot Sewer Lines on l_01 lAU1orptlon Area on Lot 90 ' 75 ' 1 105 ' :lotnst Septic/Holding Tank on Adjacent Lot Closest Sewer Lines On Adjacent sot 'Closest Edge of an Absorption Area on Adjacent Lo 90 ' 80 ' 117 ' t toxic materials are stored on the oroperly,including fuel tanks,paints,lubricants and other petroleum On Lot On Adjacent Lot aced materiats,Pesticides, fungicides or herbicides,indicate distance from nontamirtants to well casino None Non e tater Eiarntve Taken uv (Yana Sampler it Anderson Engineering L nut's, )(Ex' Engineer P. O. Box 240773 Anchorage , AK 99524 0 Banker G GovernmentOffialal _ later Sample Results: tt134 t ace Cony 94' Santini;tory Date 6/2 9/9 5 L unsatisfactory • Date' —.— :comments.Recommendations •--_..__._..._._.. 16-0406(6/93) Alaska Department of Environmental Conservation Report for On-Site Water and Sewer System Certification Page 4 of 5 III.WASTEWATER DISPOSAL -•' Package Treatment X�f' Septic TanklAbsorpnon System I Q(Sper,ly Brand Name of Proaavet • HOldinp Torok • Capaliity or Tank Where Waste is Diw1 osed - Frequency holding Lank purrtped s„ )),�-_ — 1 ,250 Gallons I — Septic Tank Ouau Other 18pecityl X XI U:cnarat>d ttio Onsite Leach Field C IOuthovss,I netnereror,rtc r U New System rani•...m ,n%:41,Pt Data 4nssalled A Plus Home Services 7/19/95 1.1 Installer ❑ Diner Tyoa/Manu1 hlrm I ! :1.anrt Bar.lder No. Steel/Anchorage Tank __....___--- Santer Tank Sue SGationsd Number 01 Coinparfmsnts Bed type or elating 1 250 Gallons Two SM/SP yr..Soil Absorpttol System _�- �Dimensions/Size Boil Absorption Systemt De!ouantity Backbit Materiel used for Soil Wide Drainfield 851 Long X •5 ' Wide X 4 '_jQs°TtOf(SvltR' " 65 Cubic Yds . -Pre.Ol.iHHOA Tot Results Petctdation Test by. Memel 15 Minutes per Inch Mike Anderson !v.nnt um Ground COvar Ooet Absorp• Molimen CItoon,Cwet over StipL•c ClosnOnt P1 as.'Caas Installeq on CleenOU1 Pipefi/CaP$installed on UOn n•ea Tana uep eelk #b,orp iiOn Syttam 4* 4* Yes 0 No VIYet ` No -- _— Feet Feat. Were• SvdnlY Sperm an Lot Neatest Water Supply Source on Adiecant Nearest Sony of Wates Wales Tebbe/Bautrack Lot Lane SIVeratrnn D'stanc to 105 Fes, -a 90 Fear / 100 Feet > 6 Feet 10 F'et •i:ommenrsr Recommunriatwtts Insulation placed over septic tank and absorption field in areas where ground cover was less than 4 ' . A diversion valve was installed between the new and existing drainfield . The valve is currently closed with effluent flowing only to the new field . l 0 Existing System Name eat enstaliar Date implied ._ Owner%Builder C Installer L! Oilier TYOe.'Mar.JtbCIUtet No. _ 5e1.t.c Tank SrIC IGallonsl Numbe.of Coer•partrnents Soil type o. Ruling TYue 5011 Absorption System Detains+ons Size Sore Abinmttnn System I 1 yperpuentity Bark fill Matcriai Niro for Scat - - �A04Orlr+frOr.Sy6nrrm Artoquacy Tess Resultl �,.Ant^giiecy Tesf Pertormp1 By tAttarh COttyol napprti -1)ate Sent Tans Pumped lAttach COPY of Rea,OtI ENass 0 F .] Pats nr .urs.:,,ound Cover over Ah,Orp Mrmrnum Cir nun,Covet oval uentei. Cotonou(Pipes.Caps i••nrnllera on Cleanout Paces cant.Ina4ailad on 1.01-.Aro. Tank Senirc Tank Aalorptaan syr!etit 0 Feel Feft� Yes NO 0 Yes No Were.S•ippiv 501.41?e on LOT kiasrest Water 5up1.4•1/SO;arc.e an Arllacartt *nearest Rogy of Wats,Water Tames,Dogrtrdt Lot Una Ear arat.On Lot Chst.lnce 10: Feel mics -� ._.._.t'es't _ Foal Feat e.n•r.-ne'ts,Rararnm,ndat.nns I certify that the above Information is correct: Sian,urs �fJ" Tyoett Pnntetr Naive ' Titin Rng;.Cnrt Wo, Insti4N ate u aU ��.Lk — —�""` NIfc, /1-No�zrv4J 43 b1 6-''! OF ,�; ' �OJ9c - NOl'E: Must be signed by a professron,yr engineer, asr�,y ,a■'�se'••eily� i�t,!! /s' /* 'e I 1 f,.„,..„.,.....,._... r 49L .N *�' y 1 ,eek/ ._... 78,1 `. s r 41 Yi. •Y.1 e• t--.....- t. s sse..r., . 'Mtrhna Atlttarron aRepistalel Pofenion.f+ �4 t° ^s. Ellyn*.r ,... -i o ia.nfnt i o tt 61ocLo rinn•trtmnnt ed Cn......nv........1 r•-...._..,,..:_- ':i C. '^r... . _... . ‘:-.4.g0 E . LOT 7BLOCK 2, VALHALLA ...."'...N , z..:. K .,V z, SITE PLAN SCALE 1" = 50' Lt. \ • -...., \,,,,.. V-) __ ____ ..____ _ LIC -.. t.) a..'%' ) ik4 I / ( -",,, •".. 44 A • �` , 00 7 �/ _641 LoH-. isci- _ - �,' �. ,Zo O 0N, o -7 - 1 ( `l . p it 1 • • \ N. , Aon C \ ,, �' , 2 OK.'AJ11', ° ., \ .. \ • ../ / ii x ,\Z \\7%... . .. ..--------7. %.-4 '02. . ------ .4.: . / , 1‘7rilijen, • ,,... .. . \\\L . 7 VAI Ix 6,6, -.,---:.•'•--.;,,,•;7. -.'.:•::....:•,.-. ---. -. • .- •• . t 1� 'I • _' Ya..^4'n�f-n.- , •e-•C•`� J 3 tir c...- f .., ..•7 ��•`L • 1Ms lief e.ss ao Lp aad ••• p ' ^4, .an Cram. .� .i�•.M t"�.*-is,-"..r..: And n 43 J7' �PO• z°,p�d• �r3O * i I . - ff 6) , V } F tti JOB SHEETIO. OF )T 7, BLOCK 2, VALHALLA CALCULATED 9Y_ ‘q DATE !z3 j9> - CHECKED BY DATE SCALE - I I i I I i i : ' i i €XiS /146•_... Z5`� 6Ac.L.o4 . . i 0. o i 4 l ; • i I t -`.._.__i .. I ! _ ' . . _.._4.-x.l_s.24 q 3 x_ _ I • ` -t1'f7 i • ; i 1 i ; it i i I i .-, f ' i i . _ . SYSTEM PLAN :7 SCALE NOTE; 1. Verify the Integrity of •:.3 Existing Septic Tank. 2. Intercept Line Out of Tank and Install New Line and ,.its as Shown. -.:*"..,� 3, Install Diversion Valve and Tie In to Exisingotr ugh, err v o,a4.e,. ''a�Ci,�.. .. 4, Diversion Valve Co Remain Closed. ir,kr` 0 ..Qo: $, ' 144 a• �5 Mi6h00i E. l nd•mar ? G.;or W$ NI otv <31' •� !r Ca �-�-�- 11%, Pr/OF I S•'�,: :7•,•siss.W ,XSI,ivin,�:nsOm2,R'.TvOoi[P..IE 11.(10iASZISON •.V•4A-4.: i,,- - SYSTEM AS t) UILT &MEETNO. -[- LOT 7, BLOCK 2, VALHALLA r.ALCULATEDBY rnT(_ CHECKED I3Yr jQ� 0ATE SCALE ( ,, C..� t fEY j -':, STATE OF ALASKA I 41.; DEPARTMENT OF ENVIRONMENTAL CONSERVA. AN ...its, ' il - t� APPROVAL OF ON-SITE RESIDENTIAL WATER AND SEWER SYSTEMS PROPERTY DESCRIPTION Trot BlockkP. Swnrtivisi}o(7n or U.S Si.wev )yAc vzsf/1`r /- 3/6 Car flee „s -toe Ap Iicetmn N�.M-a ," The Department of Environmental Conservation does not guarantee the continued satisfactory perform- ance of the water supply and wastewater disposal systems. The validation dates are based on evaluation of the systems using accepted engineering practices and assuming satisfactory maintenance. WATER SUPPLY The water system has been evaluated and found to comply with 18 AAC 80, satisfying standards for system construction and water quality of Class C water supplies and for minimum separation distances as appropriate. �/ This approval is valid for --2 ` months for the Water Supply System from date of issuance, pro vided the system is properly maintained. . 'Jame ar Titi,. _.. Oat*, e /Sof ..._J vG d,�' WASTEWATER DISPOSAL The domestic wastewater treatment and disposal system has been evaluated and has been found to be in compliance with 18 AAC 72 for a 0 single family multi-family unit with total bedrooms, satisfying the requirements for design, sizing and construction of a wastewater disposal system. = - —2 G,f ^onth s 'or t`•g -- Dirnrrat l_ ..- -'1'te of is- suance, provided tnL sy stern :s properly maintained. Receipts for Septic Tank Pumping, which is required every 24 months, must be retained for a valid approval. t.terne Mlle . . Oats—_ 1r ' La ...-- is ..0'. 11 fc( 18 0404i6;82; Distritr.ltou: Whim 89gk?l..anc:ng Io ttNtOn•Canary Aapticant,Ptpk - De artment STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION APPLICATiOrJ FOR ON-SITE WATER AND SEWER SYSTEM APPROVAL . GENERAL INFORMATION _ _epee Description of the Location _n I a_ NJ A.E5 Se--c- c - inelicaf t Name A iicent is:(Check one) Bank ❑Certified tnataller No. J( yy, Loc KItc.._t, L O.vner/Builder aooress l$Jtreet or F.0.foal Typo of Residence�,{ Notal No.f Bedroom9 A �e) 5- (ru,1 DL 1)r L V O Single Family ig Muiti•Fsmify :ity.State a d Zip Code Tefephon! Send Approval tO. *.Applicant =I Other {Give Mama& Address) U.WATER SUPPLY SYSTEM ;au ice of Water and Containment(Check all that Apply) Type of Water Supply System Treatment of Water (Check all that Apply) VVte l IOrilied or Driven' 0 Surface'identify, (Private None ❑Chlorination L Rao' Catchment _ 0Filtration Otaineral Removal LJ Other(Identify) r'ubl;c(Serve:more then one I! Holding Tank family; ❑Other. DLt p fed Wall Da'a Is the Height of the Well Casing more than 12'•above the Ground? (g Yes l No Is a sanitary seat Installed on the well casing? ea. yes 0 No v Is drainage directed away from or around the coning within a radius of 10 feet of the well casing? V1 0 No Crate Drilled 1(�11 Depth of well ;Feet{ Static Water Levo)(Feat; Yield far Available) © Purnp Rate flf Available) 5114Q.�1fQ. 1-5/ .3.2 / /5 Gal/Min Gal/Min Seneration Distances from the Well Casing to each of the Following Sources of Contamination antre-l-+oleu,i;1ar•.4, .)„ Lo: 'Bawer L'nes On -.of — 'Absorption Ales on Lot $s, .0 f J4 ica_4/' CD Gaeest Sept:cMoldm Tent on Adjacent Lot Closest Sower Lines on Adjacent Lot Closest Edge of an AbsorpttomArea on Adjacent Lot 1131 Ai/,-- pev • OD i; r,.,r. rr aenr ..-4 4's rtO•ad On!ha p uPe•t. ;:i..d,nt RA 01 1414 i.p: . _. :J^.1 atr-v pa-r.: 3r' Lar On Aa„r_ent Lot nonoil materials,pesticides, fungicides or herbicides,indicate atetencc•t -..„ r rc::,rninanrs to well cat-no ./0/'! T• Water Sample Taken by: Marna Sampler Is: !// _1; . ,U.A./rte/r A l-`-' , ai-L 0 Buyer G(F.nonetir I GOOD � s U.) 3.5t- Jr 1:j f r.d,01Q3_ it ` et9ca3 0 Suns` -- Gc+rernmentQlr'.c:u, Water Sample Results: A 0.31/1rg—Attach Copy Satisfactory -Date' ❑ Unsatisfactory Date: Coomments/Recon;mendations: // �1 / / ,� f U1 Xh�! 36 ?tic-t faire in 4".e. _t ,- AngTashte5t I(p�5 /;e0 ) fry t .i,,t-t€-t, 4 eJ'�I I certify that the above information is correct: J Signeo-,rr Typed/Printed Nemo Titut Data — ._ III. WASTEWATER DISPOSAL -, _ 74 $eotic Tank/Absorotion System 0 lBpac 1+Y T8rraantmenatrn. o or rrucess) holding Tank Capacity of Tank. Where Watt:is Disclosed FreduenCV of Ptomains(- 6ox.ly r' r /v J- Septic Tank uttr�a11 //// , Other(Spacifyr Discharged To: A U (Outhouse, Incinerator,etc.) ❑ New System Al /4— _ ..... Na-na of installer / Crate Installed 0 Ge'I.tlea installer 0 Other. 7YPeda•len'itnctt:re' [i CwneriBuilder No. _ — _____ .,... ...__ tiepr.c o- tiaur.c Tank site(canons( Number of Compartments — Sell Type or Plating Type Soil Abeam nnn Stratum OirnenslonstSito Spit Absorption System Type/Quantity Seckfill Materiel used for$pil Absorption System Percoiatlon rest Results Percolation Test by: INemel Mir r' .im llrciund Coyer ober Absoro- Minimum Ground Cover Over Septic Cleanout Pipes/Celli installed on iaanal;N Pi as/Ceps Inatal ied On tion area Tenk SeinntTank Absorption System Feet Feat [i Yee 0 No El Yes ;I Nn Water Suooiy Saurce on Lot Nearest Water Supply Source on Adjacent Nearest Body of Wager Wales Table/Bedrock Lor Line Separation Lot Dietenca tel Feet 'set Peet Feet .re Comments/Recommendations I certify that the above information is correct: Signature Tvp,a/Printed Name Title.Reg,/Cert.No..Inst. No. Date NOTE:Must be signed by a certified installer,professional engineer or DEC Staff • . Existing System r Ns'ne orA nstalier Doss fnttalIeo 6/25-ArZ (trr, AdCcrtifiad Installer f� Other. I VAe•'Mitnufaotwar U Owner/Builds. fr.e-r /5 Septic Tark Site(Gallons) Number of Compartments Soil 1 voe or�Rating `� 2 7Z1"— Tvua soil Absorotloii Svstntni Dimensiona/SIze Soil Absorption Sustain i ioe/QVantity Backfill Material uses for Soli e AbsorptlOn System .T4G-oci7 q2.5 x 3.3 x ! ,a,4).0-4^ S rs Adequacy Test Results: AdeoueCVTait Performed By:ltlttach Copy of Report) Detre Septic Tank Purnned(Attach Copy Of Hera( IX Pass 0 rail t /Vrtlei,Y' - 1 r GCS ' G1� � _. Minimum Ground Cover over:i,ncu,. M r..1rum Ground Coale.u'var Septic C.eeniuut Pipes/Catra lussasicu or. Clea au:Pipet/Cs0t Inerellro ani Slots Alee y I ank r'� ap ir_Tank Abssoorrption System1. ` Feet /taS FerOt s.es No Absorption i.Yes li NO Sapa'etion Worm.Supply Source on Lot Nearest Water su ply Sou rre on AOjac nt Nearest Body of Water Water Table/BndrpjcIt Lot Line r y J f Lot /�� J ) ! I ej T�istanaa -n' g,c 7 1 n 1 .' _I`f _]f1�3_1, �1 _ Fe,. .-)CIO Fan- etv..X.�t +r- Fahr f F1 %.u'r•rridn la , .'_a-nm■nate--ii ._._ -_-- / L AUL CL hiP,•41/ r te !e//�."7/ 1/,7,444.1A744;r7 t 1.2.-Le ,erieeti /) 6le Gr- v:4 11.P- GvO... -s:, I cl:r'Lay that the above information is correct: signature TypedfPrinted Namur Title, Rag./Cert, No., Inst.No. pato e____._—_- 1r/b, c— P'.O 7-E. Musr pit signed by a professional erlgineer- G��"I SEAL Registered Professional j(313LOT .rte .. Y= -,y-A,L L.4 • ALASKA ENVIRONMENTAL __ / SHEET NO .. or 1 CONTROL SERVICES; INC. 1200 West 33rd Avenue, Suite 8 CALCULATED BY T• / r)/'/7e.47`" 3ATE 7/2"Ir �' ANCHORAGE, ALASKA 99503 CHECKED BY _ DATE (907) 561.5040 SCALE / 4 -SD , -- i .l'�r ppp` • / _ .. _ ... _. .. .. ....i.-.. ... .....__.. l/ J' / et 4 , . ,___,ILL.., ________ : ,. . ; „ . . •,,T.: .• fi.2epeocm..• f i.... , : ik • " ' ''..!'' .'' I P4�5 ,'sl tri:. i7�� .... __ .. ..... __, ... 4..tis6A— i I ) ----i 'r \III • Ili, _i_ -- 7r....le t.., J, ' r y \I\ 1 e..i , i /, 2,- 7 ---•.<�. Lbr _, ', 1 i • LOT 3 { • Lnr..( I V �- i o ot. ALASKA ENVIRONMENTAL JOE! VAL y,e;1.LA 1-6 .83 CONTROL SERVICES, INC. SHE,1 N« Z Or 1200 West 33rd Avenue Suite 6 ANCHORAGE. ALASKA 99503 CALCULATED e . 6• rrter DATE /4/5-4 _ Phone 561.5040 CHECKED BY DATE SALE - i• 11,414, R` 0-iitir"'6 ,,. And pan .V—8t� Xr'�! PAPOZr.Y No ..,e,.c L041t-4- _�.. k'ni La % Lar iiEGL 4- i�..� I _., ter rtl Loi' % 3 • LOT _... to'" 5GGT 1 _. .. ...... _ _tdeta.• :.-dam C4. Jforwsps.v /3V-141' _. .. ... j ......... .. _,1 I ......- . . lot q o r,! to r - vI til 17, ii i 0, ..._. a - ` . ,„ L I aT tODr cot r0 Y t UT u - u Y f_s r ii i or ,z.. '� LOT► I.Of 17 J UTZ FM,Pr ... 'RO 4 0 --. 6en,era4 Stops: - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO'FECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchora§e, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAl_ SYSTEM AND/OR WELL INSPECTION REPORT NAME V~AI LING ADDRESS LEGAL DESCRIPTION LOCAT,ON Manufacturer Liq. c~ IF HOMEMADE: Inside length DISTANCE TO: Dwelling PHO~T ~UPGRADE w0, I00~' No. ofline, j Lengthofeach4,~.~~ l ic c k Z, L NO. OF BEDROOMS PERMIT NO. NO, of compartrrlents Liquid depth Well PERMIT NO. Liquid capacity in gallons DISTANCE TO: Foundation Total length of lines ~4 2 . :5" Top of tile to finish grado Width Material Nearest lot line ,¢~.,[ inchesTrei~ch width inches Length Deptll PERMIT NO. Total effective absorption area '7ZZ ¢~.x PERMIT NO, Type of crib Crib diameter Crib depth Total effective absorption area Well guifdin9 foundation Nearest lot Ene DISTANCE TO: Depth Driller Distance to lot line DISTANCE TO: Buildin9 foundation Sewer line Septic tank OTHER PIPE MATERIALS C..E PVC. SOIL TEST RATING l- -- INSTALLER REMARKS ' APPROVED DATE LEGAL Valhalla [ !~{ (;ii!::i! GAAB HD I GI~ ~ER ANCHORAGE AREA BOROI ~1 DI-rAR'I'MEN¥ OF EI~WF~0~ME~TAL QUALI~, 3B00 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION MAILING ) ' ' ' __ADDRESS t~ ~ ~ ,' /~ I , ~ J ·PHONE LEGAL DESCRIPTIONL '~/ - ~_~ /,__" i/; i I,. ' ' SEPTIC TANK: DISTANCE FROM WELl './ LIQUID CAPACliY ' ~ MATERIAl GALLONS· INSIDE LENGTH NUMBER OF COMPARTMENTS INSIDE WIDTH ' LIQUID DEPTH SEEPAGE SYSTEM: SEEPAGE PI1: NUMBER OF PIIS__ / __ _. OUfSIDE DIAMETER LINING MATERIAL__ :.__~'" NEAREST LOT LINE .... ~.~ ._ OR WIDTH DISTANCE FROM TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ·LENGTH i ' , DEPTH --, BUILDING FOUNDATION. · ' SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL ~c FOUNDATION~__ NUMBER OF LINES DISTANCE BETWEEN LINES NEAREST LOl HNE TRENCH wiDTEI ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE__ TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE DEPTH: TOP OF TILE FO FINISH GRADE _DEPTH OF FILTER MATERIAL BENEATH TILE_ ___IN. ABOVE TILE :}:,,,U,, , DISTANCE FROM WATER WELL: TYPEL ~'" ' )' , DEPTH~ , BUILDING FOUNDATION ...... SAMPLE .... NEAREST [ NEAREST SEPTIC '~7 C,~, SEEPAGE / , / ' OTHER LOT LINE "' ~ _, SEWER LINE .... TANK_ , SYSTEM_. ' ' . / , CESSPOOL , SOURCES DISTANCES: DIAGRAM OF SYSTEM ~'/ / ' '/ ', ' APPROVED~_ DATE GREA,ER ANCHORAGE AREA ~3OR,..,UGH DEPARTMENT OF BNVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME OF APPLICANT .~//~> INSTALLATION LOCATION INSTALLATION OF: SEPT]C TANK ~/- ~/ - -- SEEPAGE PIT _, DRAIN FIELD , OTHER TYPE AND SIZE OF FACILITY TO BE SERVED · .. ~ FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE BUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK ='~ SEPTIC TANK ., SEEPAGE PIT ~'" , DRAIN FIELD , SEEPAGE PIT ~ 4 INCH DIAMETER CAST IRON SIPRON PIPES ON SEPTIC TANK AND SEEPAGE Pit FITTED WITH AIRTIGHT REMOVABLE caPs. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITy or LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS Of (~;REATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-6B AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, -- APPLICANT'S SIGNATURE dREATER ANCHORAGE /,::EA IlOI,~OUL BEALTH DEPAi':T V.E:tT 3~7 E~GLE STkEE7 ANCHORAGE, ALASKA 99501 CASE Performed For- //.qF/? i: % ~;cA. 55 i. ;::/'-( Date Performed ~ .- Z?~q~_-- '7/ Thzs Fc~m Re~orts a: So.is Log Depth Feet Soil Charac~erls~ics Was Ground Water Encountered? /~ ~ if Yes, At Whaz Depth ~ ,xeading ! Date I Gross Time ........... .-_T.F----Zc Location Sketch ,'{et Drop L.--ZL ...... ' ..... Proposed lnstal~l-6~n~Seepage Pi~ I)rain Field Depth Of Iniet ])el)t-~T~--~t~ln ~[Yit Or Trench ..o,.......,,,.__:~~~_~:~_~ o ~,-ro~ .no~ ~ .... ~ ..... ,-.-, Performed : '. ~]~ COMSUZT~ Time Time Date ~-at~o I~ate Inspector Insprec~or Inspector Comments' C~n~t'ional Approval '- Date Sewer Installed ~ Permit No. Septic Tank SIze :1'~._ ~ Holding Tank Size Soils R~ting Well To Absorption Area t ~ Well Log Received Well to Tank ~ ~ APPLICANT FII. Lg OUT LOWER HALF ONLY )roperty Own*~ ~ >'~ t.~ tV:/~/~, Phone Mailing Address ~ ~ ~ /~ ') ~ --/~ Address Lending Institution /~/~ ¢~ ~ ~[: ~ ~ - Phone Address Realty Co. & Agent Phone Type of Residence ~ Single Family Multiple Family ~o~ o~ Bedrooms ~ ~ Other W~ter Supply ~ Individual A~ACH WELL LOG. A well log is roquired for all wells drilled since June Community 1975. For wells drilled prior to that date, give well depth (attach log if D Public Utility avellable.) S~w~e Disposal ' DD PubllCHoldingUtilitYTank When Connected ,o Public Utlllty:~ '~ 'Z~o NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INrrlATED. MUNICIPALITY OF ANCHORAGE Development Services Department ` '_T Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 015-212-19-000 Expiration Date: 7-29-19' 1. GENERAL INFORMATION Complete legal description Valhalla B2 L7 Location (site address) 12200 Shiloh Rd. Current property owner(s) Legend Homes, LLC. Day phone 351-8712 Mailing address P.O. Box 670191 Real estate agent Stephanie Koontz Day phone 351-8712 2. TYPE OF DWELLING: 111 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 4 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 550 Waiver Fee $ Date of Payment Y/23/9 Date of Payment Receipt Number 23 6 657 Receipt Number COSA# O SC)q 112 - Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm Eklutna Engineering, LLC. Phone (907) 355-9820 Address 19162 Mountain Road Chugiak 99567 / Engineer's Printed Name Curtis Townsend Date / ? Z "loc�' :.`. GOF 41-A, �1 /,..•• 4 :9S� 6. DSD SIGNATURE f* �� * SiSystem #1 Approved for bedrooms .••• Y pp / C rtis L.Townsartd System #2 Approved for bedrooms +fk<�•. Date j 2 1, .�. Disapproved �(il����"``- Conditional approval for bedrooms, with the following stipulations: it olll(((((qt� 114"1TY OF, (f ON-SITE WATER AND WASTEWATER PROGRAM • 7'9M SEI Ct,\\�� By: J ! Original Certificate Date: `y - it iq 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 ) 2y y„ COSA Checklist blue sheet COSA Checklist Legal Description: Valhalla B2 L7 Parcel ID: 015-212-19 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA ❑� Well log is filed with Onsite (or attached) Well production at time of test 8.1 gpm Date drilled 1971 Water storage tank volume n/a gallons Total depth 75 ft Well disinfected for coliform test? ❑ Yes ❑Q No Cased to 75 ft ❑■ Coliform bacteria is Negative ElSanitary seal is functioning correctly Nitrate 1.75 mg/L ❑ Nitrate less than MRL (ND) Wires are properly protected Arsenic <MRL ug/Lt❑ Arsenic less than MRL (ND) Casing height(above ground) 18 in. Collected by Brandon' On-Site Services, LLC. Date of flow test for COSA 4/3/19 Date of Sample 4/3/19 Static water level at beginning of test 34.3 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 24 years ❑ Required maintenance completed Tank type/material steel Age of lift station years Measured operating fluid level in septic tank 49.5 Lift station material ❑■ Standpipes/foundation cleanout per record drawing Comments: Date of pumping 9/5/18 D. ABSORPTION FIELD DATA Which system tested (date installed) 6/28/1995 Adequacy test date 4/3/19 0 ALL standpipes present per record drawing Results p Pass For 4 bedrooms Total measured depth from grade 8.2 ft(max) Fluid depth prior to test 3 in Measured depth to pipe invert from grade 4.5 ft(min) Water added 2619 gal ❑ N/A—pressurized field 2g 5 New depth in Monitor tubes go to bottom of effective. If not, state Elapsed time 1230 min depth into effective Final fluid depth 22.5 in ❑� Code-required soil cover over field 616.2 0 System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) no date of test) Gallons introduced 2000 gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ,.82.8 ft ❑✓ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' 10 Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank> 100' ✓❑Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' ❑✓ Yes if No ft ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft [7] Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5 ft Surface Water> 100' ❑✓ Yes if No ft Property Line > 5' p Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ❑ Yes if No **97 ft Water Main > 10' ✓❑ Yes if No ft Community Wells > 200' ✓0 Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' p Yes if No ft Private Wells > 100' I✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' ElYes if No ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *5' from deck sono tube. **83' L7 well to L7 tank. 97' L8 well to L7 Tank. MOA has on file the waiver for well separation distance. .�t\aa\ G. ENGINEER'S CERTIFICATION .:, OF AL a�\ rN .r% j.•.;t1 I certify that I have determined through field inspections and review ag.• t `� 11 *0 of Municipal records that the above systems are in conformance with *. 1.� O/ MOA COSA guidelines in effect on this date. / F'NGI; =t5' I ,, � ,. Date r /94,+iC�F��o.C �c�V�/ l PROFESSION.,,+ COSA Checklist yellow sheet MUNICIPALITY OF ANCHORAGE • ,, DEVELOPMENT SERVICES DEPARTMENT (• t.- r 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite // Septic Tank Advisory Certificate of On-Site Systems Approval #0SC191122 Subdivision: Valhalla B2 L7 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 24 years old. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. Y.7< 4 -• � X41+ u .4:s • 1 ' T .?� Jam' • v 4. p ' yf 1. iiiv2 Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org 58959'19"E20000 1 4• i e i i i 1 1 ii --- �'�7 -'-1Ai Q Qi o 0 w 0 0 1 Cf. P 0' o o 0 �' s� 0 II M O C 2G� ___.___......_. 0 IV o L r u -9yc� -9�t1 0 i ti :' 1 1 I 1 .` -1:::-.11 O q., _- _.. 16.9 �i M WT,6 . N 89 59'W200.00 .``""''''"<,f,-=-' '-1 1 AS-BUILT SURVEY 1" = 30 ' gO'PDOOO4 NO CORNERS SET THIS DATE o�'\� �FA�.715'�0 I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY �P ,' 1- 0 O* 49 TH 37.QO THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE 0i' 'V CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN O S <A( O NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN EXIST OTHER THAN NOTED. 6'01 m • o`O HEREON ( UNLESS INDICATED) DATED AT ANCHORAGE,ALASKA THIS DAY OF QN SHANE A.HOLT• Ati NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE , 2019 a LS-6914 ..-'„,,,,, 5?p PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. P OQ4a _ ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. HOLT LAND SURVEYING �prO Jes SIOOa� �'6'Q ANCHORA9109 GEEAK DRIVER 99507 4ODOO��o� 14202,FB 1%14 345-5513