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Home My WebLink AboutVALHALLA BLK 4 LT 2Valhalla Block 4 Lot 2 #015-211-03 (~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [] NEW MAILING ADDRESS LEGAL DESCRIPTION LOCATION ~ apaclty in gallons IF HOMEMADE: t ~ diameter ~ ~ Type of crib Crib diameter Class t ~ISTANCE TO: IAbsorption area NO. OF BEDROOMS 5 PERMIT NO. linside length Liquid depth Dwelling PERMIT NO. Liquid capacity in gallons Dwelling Material Width Material Nearest lot line ¢)~ i Trench width ~ inches Foundation 7 J Total length of line~ Material beneath tile PERMIT NO.~;5 (~. ~ ~.~/~ Distance between lines Depth PERMIT NO, Crib depth Total effective absorption area Depth Driller Distance to lot line PERMIT NO, Building foundation Total effective absorption, area Sewer line Septic tank Absorption area(si OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78) PERI"II T DEPRRTHENT l:4El::lLTIq Iaii4D ENVI,ROI',II'IE;NT?II_ ,.;:O]-E;E:TION ,E',;2.¥ '"L'" :STREET., I::III',iCHOI'4:FIE'iE., Iai-:::. 9950:if.~--~f'~~//" ~ 'Z,~ ii'-,~ ....... :E; % -'T- FEE 8302:5,4. ;:, IaF'F:'LICFII'.iq" C, Oiiql::lL£:, £':;. FLqL. L. QI:,.I'.'~:; :51;:ia EiElY, :t. 586 L Q C Fi T I 0 N L I- LEGAL LOT ;2 E~L.[::: 4. VRLHFI~:FI SUE: LOT tE;IZE 3:,4.5.-4-938 9999 E;C!I_IFIF4'.E F'EET T'T'F'E OF 2;OIL REr:5ORPTION S'T'STEI'I I~5: DFtF'IINF'IEL.[:, I'IIa::.:;IHI~IH i'.iiLlii, iEsEF.: OF' BEE)ROOf"IS; = 3: ~:';OIL F,:FITING <SQ F'T,-,'E:R:)= ±30 Tl:tE I:ifEQUIR[ii;£) .'.:.;1ZE OF ']'FIE 'Z';Oll._ FIE:SORPTICiI'.,! S'T'L:;,TEP'I THE LENG'TIIi [:'IHE:I",IE;1C*I'.,I IE; TFIE L. EI,la Fl:-I ..... "Ii",1 FEET:) LqF THE ..... FREiq. H '"lq:::'_ I_':,RFI I i",IF I ELI:;:,. q"HE [:'EF'TH OF:' R TRENCH "F,~: F'IT I.S; ]"FIE [:,I'_:,TFd',!CE E:ETHEEN I'HE _l..l~.ii-[IC.E:' - ' ' OF: 'T'HE GRCILIN[) FIN[) THE BOTTOP'I ElF' THE: EXCla',,,'I--ITION ,:: IN FEE"r). -ii" E-ii FiE '-if' F;~: [CE if'4 ~3: ~--al B.-ii Z El:. -¥' ii--ii Z ::~; ~";~5 _ ~.T.-~ ,;if~ (C'~ F- EE IF.,~ -ii'" .. THE GF..'R',,,'EL DEPTH I:5 THE HII"4IHUH DEPTH OF GRF:I',,,'EL. BETII4EEN THE OLITFFILII.. PIPE FINE:, THE BO'I'q'oH OF TFIE E:~4CR',,,'RTION ,::IN FEEl'>. F'ERI'I I-F FIF'F'L I IZ:l:ll'.,ll' HiaS; THE RESIZ'OF,I'.2; I E: 1L. l "F"r' 'T'O I NF'ORH -FI--II S E:'EF'FIRTHE:N]" [:'UR l I"iiG THE Z N:STFII_LIaT I 01",1 :[ Iq'_SPE:CT :[ 01",1S OF Ial'.,l'¢ IIqE:LL:E; RDJ'RCENT TO "EH if'.:T, PIIq:OF'EFE:T'¢ FINE) TFIE IqlJi'1BEIE: QF REE";Z[)E:NCEf5 TFIFIT TFIE I.qEL.L !-,.IZLl_. L:SER'.,.'E:. BFICKFZLL_ING OF IaN'¢ :5'T'S;TE["I II4ITHCILFI" FINIAL II'.4:~PEI3TIOIW RI'.,IE:, IaF'PRO',,¢IaL B'T' THIS [)EPRRTHENT HILL BE: %LIB,)'EC]- TO PROSIEC:I_ITION. t,lI?4:[l"lLli'"l B,I:i~;TFII',ICE E~IE'I'I.,IEEI',I F:I PIIELL. FIND Iah,l"r' ON-'-SZTE 9EI.qFIGE D:E:SPEI:~,RI_ 'E,"r'S'T'EH ii:S 100 FEET FOR FI PRZ',,/FYFE HELL OF,: :LDC~ TO 20E~ FEET FROi'"I R PUE',L:[C I.,I:EL.L E:,EF'ENE:,ING UPON THE T'¢F'E OF PLIBLIC 1.4ELL.. HZi",lIHiiJii'l DI6TFffqCE FFd3l:'l l::l F'F~:I',,,'RTE 14ELI_ TO Ia PRIb'IaTE SEI.,.IER LINE I2; ;25 FEET Fliql> TO FI COI'III'ILINZ-F'T' 'SEHEI:::: LINE I:B 75 FEET. OTHEFII REII;:!I..IIF;:E'I'IENT'.E; I'iiia"r' IaPF'L'¢. SF'ECIF]:CIaTIONS FIND CCINSTRUI3TION [)IFICiRRHt.E; FIIRE FI',,,'R :[ LF4E',L.E TO Z I'qSURE PROF'ER I I",I~;-FIaLLFFF I OI"L i CER'I"IF"r' 'FHI::FF 1: I F:iH FIaHIL. IFfl:;.: I.,.IITI-I THE REI;!UIF,;:EHENT5 1:O[~: ON..-SI'FE SEI,.IEI:;:S FIND I.,.IELI_.'E; FIS SET FOI::~:TH E','T: THE I"iLII',I I C I F'ial._ I T"r' OF I'":II",II~:'[~Z*~E. 2: I HIIJ... INS'T,:II.J.. THE ::5'.,"STIEH II",l FI,::~,,!~I,::E 14:['I-H ~]bl~ COI::,E:E;. 3.: I UN[:,ERL-q?Flii,[:, q"HRT THE ON--SIq'E 5~ ~]"EH r"Fh. F. EL:.!UIR[E ENLFIRGEHEII'.I]- IF' THE RE'S :[ [.,ENE:EII~~ -'~'-~:'J~"~'"' ~'~--ii: S; REi'IOE:,EL.E[., TO ,I I',IC[.UE:,E I'ILqR'E--I'FI'I(IN 5: E, EE:,F{I_3CIHS. :iil; I GN ~I'F'F[.. I C.i?IT [:,Clii',IRL[:, :5. FOLJ...I_-IH'_-7, ........ I S'_;;IJED E ....... [:,FFrE_.%_~_ ~._ ',,,'4. 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS'LOG PERCOLATION TEST LEGAL DESCRIPTION: 2 3 5 6 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, ATWHAT DEPTH? Reading Date PERCOLATION RATE TEST RUN BETWEEN SITE PLAN I I Gross Net Time Drop ~Z tq CERTIFIED BY: Not Depth to Time Water E o0 LS' LOG r MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �� u��-3 DATE PERFORMED: — 47 LEGAL DESCRIPTION: VAI -HAL -LA y u ('L, 61 I � 1`1 J-•6 T Z - P n SLOPE SITE PLAN �L MOMMENEE] 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER �II S ENCOUNTERED? I� L P IF YES, AT WHAT E DEPTH? Reading Date Gross Time N■■...■■.■ Depth to Water Net Drop no IN Nwwwww- /nz(; /d3 7 N■■■■■■■■■ z1z3S is MMISMIMMEMIME N■_ MOMMI.■.■■■ WEEME■■■■■I WEINE■■ ■■ MEMNON 200 OWN ■■■OS■■■■■ ■■■■■■■■■■ WAS GROUND WATER �II S ENCOUNTERED? I� L P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop /nz(; /d3 7 1 z1z3S is /02cI�•P-3-5, 200 .035 y -$-s'3 io33 ice'' Z 417 214-7 PERCOLATION RATE .> 60 TEST RUN BETWEEN(A) ?- FT AND (20 '3 /Z - PERFORMED BY:r/(�:Y��/�I'♦`� �L� I r� /'Si�P.�L/� CERTIFIED BY: 72-008 (6/79) _ (minutes/inch) 2 Z FT DATE: .17 -6--" LOT � 1 2 3 4 5 0 7 8 3 10 11 12 13 14 15 18 17 0 19 20 LOT T 1 2 3 4 5 6 7 8 8 1O 11 12 13 14 15 16 17 18 19 20 D.��^�^.��^/ INC,vw" ?27DU 7�n� -��+/ W. ��/. nVBm_ / ��l ,ANCHORANCHORAGE,0rw`, ��-°�� Supplemental Soils Information. Subdivision NA Block LUT LOT T TH DEPTH DEPTH 1 3 4 5 / O 7 8 9- 10- 1U 11 11 12 12 13 13- 14- 14 15 vol � 9 "a,"\/ u - | 15- � 1G 16- 17 17 18 ! 18 1S 19 | 2O� | 2O� | LOT T 1 2 3 4 5 6 7 8 8 1O 11 12 13 14 15 16 17 18 19 20 ~,'uum :~u :E>JU,,C~;~; m~;a Bo~o~t~i:~TER ANCHORAGE AREA BOROI)'~?I ~epaz~ ~.~n[ ~ ~mvironmentcd Qucdi[~ __ 3500 Tador ]:load --Pot~ch 5-650 ~'~,~.~$~ ,AN~jH, i~,i~ii~¥[A~: ~§0t~, ,2~,9.~5~I~' INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM N? 920 MAILING ADDRESS LEGAL DESCRmTION SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY GALLONS. MA'JERJAL ~7~;J~ ~/~-~:/ -//'/. ,~/'?,?~o.~'?~COMPARTMENTsNUMBER OF .~ INSIDE LENGTH '-- INSIDE WIDTH ~- LIQUID DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMRER DP LINING MATERIAL~6' NEAREST LOT LINE _OUTSIDE DIAMETER. .OR WIDTH /?~ I ~ , LENGTH /U , DEPTH .. .DISTANCE FROM WELl ~ BUiLDINO FOUNDATION TILE DRAIN FIELD: DISTANC~ F~ROM WELL NUMBER OF LINES, ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE TOTA~,~ ~TH~''~'~ ~'~ , FOUNDATION , NEAREST LOT LINE__ , O~INES . DISTA~WEEN LINES ~__TRENCHWIDTH / IN. TOTAL EFFECTIVE SQ. FT. L' L~E GTH OF EACH LINE ,~ ......... '~EP~H-4~F-F~~H TILE' IN. ABOVE TiLE WELL: TYPE~'~,'//£P , DEPTH U/I/~ NEAREST , SEPTIC LO1 LINE /(~' ~- , SEWER LINE J-,J(") . TANK DISTANCE FROM ~ WATER · BUILDING FOUNDATION. /'¥ SAMPLE ~ , NEAREST ()~0' SEEPAGE I OTHER , SYSTEM. ,c~,] , CESSPOOL ~ , SOURCES DISTANCES: DATE DIAGRAM OF SYSTEM GREA,- ~R ANCHORAGE AREA BOR~., ?3H DI=FARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 AHcHorAGE, ALASKA 99502 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT pERMIT NO. 2!72 ? mAILING ADDRESS'~/ / /::~ / ~ (/'~/" FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL .E SUBJECT TO F"OSECUTION. · /,: : , , · ,~ DIAGRAM Of SYSTEM MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDAT]ON TO SEEPAGE PIT , DRAIN FIELD -- SEPTIC TAN K TO SEEPAGE PIT WALL SEPTIC TANK __, SEEPAGE PIT TO NEAREST LOT LINE. WELL TO sePTIC TANK DRAIN FIELD DRAIN FIELD , SEEPAGE Pit ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD_ __. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of EXCAVATION 5 FELt INTO UNDISTURBED SOIL. 4 INCH DIAMETE~ CAST [ROH SIPHON pIpES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULAT[0NS REGARDING INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBE,[} SYSTEM IS IN ACCORDANCe With SAid CODe. , /; / / A '/ ?/. ': ' . ' o GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality ~ ~330 "C" Street, Anchorage, Alaska 99503 274-4561 ~ Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Approval requested by: ~-~97~'-/V/ ~-/-/~/~ Mailing Address: L~---/~ ~. ~R~F~.~_~/ Property Owner: __~//~/ ~/~ Mailing Address:~~'~/~ Legal Description: ~z:i)T~__~ ~lOck d ~~ Phone: Phone: Location: 5. Type of facility to be inspected 6. Well Data: A. Type ~)~ C. Construction ~h~ 7. Sewage Disposal System: ~ ~ No. of bedrooms B. Depth ///2' D. Bacterial Analysis C. D. E. Disposal Installed 7¢7~ B. Installer Septic Tank: 1. Size .%//2/2_/'2~ 2. Manufacturer~~(2 Seepage Pit: 1. Absorption Area ~.~/~/ 2. Material Field: Total length of lines Distances: A. Well to: Septic tank ~ ~ , Absorption area Nearest lot line x~/~)~ , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line , Sewer Lines EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re st for Approval of Individual ! er & Water Facilities Legal Description Comments Approved Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) 3330 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES Type of Inspection: CMRO __ Property Owner: _~J~//~r ~ Mailing Address _~4~,~ Name of Buyer: FHA CONV // DaS Phone Mailing Address Day Phone 4. Name of Lending Institution: e Mailing Address: Name of Realtor or Agent: Mailing Address: _ ~uz~/~ Phone Legal Description: Location: Type of Facility to be inspected: ~d.~, ~c~N~. Bdrm~...,~ Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) EQ-037 (1/74) ~u~// 0/ Au~t 27, 197B File No.; 4-1 1~. l:Vtllard Taylor Anehorago, Ala~ka 90507 SUBJECT: Lot 2, Block 4, V~h~la Subdivision ~ Loan Approval Dear My. Taylor: Tho problem of insufficient dts/nnce be~voen ~our sewer system ~nd well has been reviewed by myself and the chief s~ita~,i~n of this department, The existing dtnt~ces ave inadeqqate and will not bo approved. Although Mr, Johll Lee did p~rsonally work with you ,md your execrator, the descrnp~oies in well distances were not rectified. In ordel, to cominuo use of th~ on-site s~wo~' system tile only ~te~,native is r~lo~ation of youP well 100 feet fl~m all sower systems. If you have uny qu~ntions ~egardtnff tht~ matte~, please ~ntaet the undm, Mgn~d, Sincerely, las Buehholz, R.S. Sanltax'inn Ln/lw Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 /~' www.muni.org/onsite CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. o~.s-z~.~.-o3 1. GENERAL INFORMATION Expiration Date: //CO .- '~- / / Complete legal description Valhalla $/D Block 4 Lot ~ Location (site address) z2~p_5 Wilderness Road, Anchorage, AK 995~_6 Current Property owner(s) Kevin 8, Rochelle Pendergast Day phone 64.6-968~ Mailing address Wilderness Road, Anchorage,AK Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing .Address Unle§s otherwis~'¢'recluested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3 TYPE O'F WATER SUPPLY: Indi~idU'al'Well'' [] Individual Water,Storage [] community Class ~ Well [] Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordnances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services, LLC Phone., 272-82:].8 Address P.O. Box ~.oo217, Anchorage, AK 99,;:Lo Engineer's Printed Name Steven R. Pannone, P.E. Date Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ~/~' Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: '.~- 7 ~// Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Valhalla Block 4 Lot 2 A. WELL DATA Parcel ID: Well type _P Date completed 6/a/aq72 Total depth ao7 ft. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ~ colonies/100 mL Arsenic: /f//) ug/I B, SEPTIC/HOLDING TANK DATA If A, B, or C provide PWSID # ~ Sanitary seal (Y/N) Y Cased to 40+ ft. FROM WELL LOG g.p.m. Nitrate O, ! ~'-mg/L Date of sample: nl[61~oz~ Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) ~+ AT INSPECTION ~/~612o:~ 87 ft. · .~ g.p.m. in. Collected by: Laura Pannone Tank Type/Material Stack Steel Tank size ~.ooo gal. Number of Compartments Foundation cleanout (Y/N) Inside HouseDepression over tank (Y/N) N Date of pumping n/~/~o~. Pumper A+ Home Services C. ABSORPTION FJEL~I Date installed 7~8/,48, ~~ating (g.p.d./ft2 or ff2/bdrm) Length ~/~ ft. Width ~/~ ff. Total depth n.7~ ff. Eft. absorption area ~4/~8~ Date of adequacy test ~/~61~o~ Results (Pass/Fail) Fluid depth in absorption field before test ~ in. Elapsed Time: ~ min. Final fluid depth ~ in. Any rejuvenation treatment (past 12 mo.) (WN & type) N Date installed Cleanouts (Y/N) Y High water alarm (Y/N) N/A System type Crib/Trench Gravel below pipe 6/~.n Monitoring tube Y Depression over field N Pass For 3 bedrooms Water added45o gal. Absorption rate >= If yes, give date New depths8 in. g.p.d. D. LIFT STATION Date installed "Pump on" level at ~ in. "Pump~el at Datum Cyc~sVe~s~ed/ E. SEPARATION DISTANCES in. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 50+ Absorption field on lot 75+ Waived Public sewer main N/A Sewer/septic service line Animal containment areas 3.oo+ On adjacent lots 3.oo+ On adjacent lots 95+ Waived Public sewer manhole/cleanout N/A Holding tank 3.oo+ Manure/animal excrete storage areas 3.00+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ;+ Water main N/A Wells on adjacent lots ~o+ Property line ~o+ Water service line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line o Waived Water Service line .. 2,;+ Curtain drain None Known COMMENTS Absorption field.J~t~ Surface water ~oo+ Building foundation lO+ Water main N/A Surface water zoo+ Driveway, parking/vehicle storage Wells on adjacent lots q~+ Waived As Built on File G. ENGINEER'S CERTIFICATION . . I ce~ify that/ have determined through field inspections and review of Municipal records that the above systems are in conformance w/~ ~0~ COSA ;./de//nes /~ effect on EngineeCs Printed Name. S teven R. Pannone, P.E. COSA Fee $., ~0 -- Waiver Date of Payment -- / -- I / Receipt Number 0~' / ;;;Zl ~. (Rev. 11/05) Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE Development Services Department Right of Way Division Departrnent ENCROACHMENT PERMIT Rl11648 THIS AGREEMENT, made this 6th day of July, 2011, by and between Rochelle and/or Kevin Pendergast and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTER". WITNESSETH: WHEREAS, PERMITTEE is the owner.of the following described real property: VALHALLA SUBDIVISION, BLOCK 4, LOT 2, according to the official records thereof, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTER owns and/or maintains the real property more particularly described as follows: The SIXTY FOOT RIGHT OF WAY OF WILDERNESS ROAD, immediately to the west of PERMITTEES property as shown on Plat No. P-644, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTEE has placed a septic system leach field upon the referenced real property which encroaches approximately 20 feet upon the PERMITTER'S Wilderness Road Right of Way. NOW, THEREFORE, it is mutually agreed between the parties hereto that: The PERMITTER, acting through the Director of Development Services, hereby grants to the PERMITTEE the privilege of allowing the septic system leach field to encroach approximately 20 feet upon the PERMITTER'S Wilderness Road Right of Way, as shown on "Attachment A," included herewith. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless, the Municipality, its officers and employees, from any and all lawsuits, claims or actions brought to .any person for or on account of damage to property or injury,, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, alterations, maintenance, repair, renewal, reconstruction, operation, use or removal of the encroaching septic system leach field, as placed upon the PERMITTER'S Wilderness Road Right of Way. The PERMITTEE shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Development Services. G:lCommunity DevelopmentIDevelopment Services~Land Use Permitting attd EnforcementlRight of ~VaylEncroachment Perm#si Valhalla, Blk 4, Lot 2, Pendergast. doc Page I of 3 This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S real property whatsoever, except only the encroachment rights described herein. The PERMITTER reserves the right to revoke this permit upon twenty (20) days written notice to the PERMITTEE. The PERMITTEE agrees upon such notice of revocation, to move said encroachment(s) from the Wilderness Road Right of Way in which it is placed. Should the PERMITTEE refuse or fail to comply with said written notice, the PERMITTER may, without further notice to the PERMITTEE, remove or cause to be removed the encroachment(s), and the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the PERMITTEE has paid the PERMITTER a one-time permit application fee of $115.00. The PERMITTER hereby waives the annual fee of $300.00. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year first hereinabove written. GRANTEE: GRANTOR: MUNICIPALITY OF ANCHORAGE ///jack L. FroSt,'J~:. ~ "Right of Way Supervisor G.qCommuniiy Development[Development ServiceslLand Use Permitting and EnforcementlRight of WaylEncroachment PermimlValhalla, Blk 4, Lot 2, Pendergaxt. doc Page 2 of 3 t ~ i1 ~:1I I, \ .II NOTE: THE EKISTINg SE:EPA*E-PIT AND i , . · J \ / l TRENCH LOCATIONS A~£ APPROXIMATE. THE I I I1 I -, / I~.ACT PERIMETER AND LAYOLrr IS UNKNOWN.I I DON FOLLOWS 345-4958 2 OF 2 t,}:"':.':t[;;1TI :'"A'-I .... :'"'g VALH/:U.^. SUBDIVISION; LOT 2. BLOCK 4. ~{}~,,;,r... "[-[- .."~,e~ DETAIL D~AWING FOR WAIVER PACKAGE Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343.7904 Parcel I.D. 015-211-03 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING O%Oq O0 Expiration Date: I~'/~.~'/~0.~ GENERAL INFORMATION Complete legal description VALHALLA SUBDIVISION; LOT. 2, BLOCK 4 Location (site address or directions) 12315 WILDERNESS DRIVE * ANCHORAGE, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address DON FOLLOWS Day phone 345-4938 12315 WILDERNESS DRIVE * ANCHORAGE~ AK 99516 Day phone BONNIE MEHNER w,/ PRUDENTIAL JACK WHITE Dayphone 223-1632 3201 "C" STREET SUITE 200 * ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class . Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. INote: Alaska Water and Wastewater Consultant% Inc. shall be paid $ at, or pdor to closing for the engineering services provided. ' I 4. STATEMENT oF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authodty 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 furfher verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspedion, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER &: WAS'i'EWATER CONSULTANTS. INC. Phone Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 337-6179 Engineers Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineetfng analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results descrfbed the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfacto~y test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimale of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal rfght whatsoever. 5. DSD SIGNATURE 3 Approved for Disapproved. Conditional approval for bedrooms. ..... bedrooms, with the fllowing stipulati~ Attachments: HAA Checklist Septic System Advisory Well Flow Advisory (Rev. 12~1) Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: ~ (~ ~- !CP~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wesfewater Program 4700 South Bragaw SL P.O. ~ 196650 Anchorage, AK 99519-6650 www.cLanchomge.ak.us HEALTH ~,UTHORITY ~,PPROVAL CHECKLIST Legal Description: A. WELL DATA Well type PRNA'FE;. Date completed ,,. 1972 Total depth .,107+, ff. VALHALLA SUBDIVISION; LOT 2, BLOCK IfA, B, orC provide PWSID# N/A Sanitary seal (Y/N) YES Cased to 40+ ff. FROM WELL LOG Data of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Arsenic: N/A mg./g B. SEPTIC/HOLDING TANK DATA Tank Type/Material g.p.m. Parcel ID: 015-211-0.3 STEEL Well Log (Y/N) Wires propedy protected (Y/N) Casing height (above ground) , AT INSPECTION ~.,/16/2002, 89 , ,, ff. 4.94 g.p,m. NO Nitrate O_.10 mg./L. Date of sample: 4/24/2003 Collected by: YES Other bacteria 0 colonies/100 mi. AKWWC~ INC. 5/2_3//1972 *FLOOR DRAIN INSIDE HOUSE. SNAKED McDONALD'S PUMPING ON 6/24/2005. Date installed Tank size t000 gal. Number of Compartments .2 Foundation cteanout (Y/N) *YES Depression over tank {Y/N) NO Date of pumping _ 4/2/2003 . Pumper, ANCHORAGE CESSPOOL Cleanouts (Y/N) High water alam~ (Y/N) C. ABSORPTION FIELD DATA I,SL:'tbw' ~X~S~NO GP,~a Date installed ,~ Soil rating (g.p.dJft~or(~) 130 Length _ _, 13/52, fL Width 14/5 . . fL System type , CRIB/~'RENCH Gravel below pipe 6/3.5 Total depth .5.85,,. fL 'Eft. absorption area32¢/481fl= Monitoring tube YES Date ofedequa~ test 4//16//2002 Results (Pass/Fail) PASS ' . Fluid depth in absorption field before test ,,O in. Water added 8.89, gal. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rote >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOW_N Depression over field NO For 3 bedrooms New depth 0 ,in. 450-t- g.p.d. If yes, give date - O. LIFT STATION Date installed Size in gallons ~ "Pump on" level at in. ~ High water alarm level at .in. ~ -~-~- Cycles tested Meets alarm & circuit requirements?. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *50'+ Absorption field on lot **75'4- Public sewer main N/A Sewer/septic service line 25'+ *TANK INSTALLED PRIOR TO 10/1975 On adjacent lots 100'+ On adjacent lots **95% Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line, 15°+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water. 100'+ Wells on adjacent lots *50% SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line **0' Building foundation 10% Water main Water service line 10'4. Curtain drain NONE KNOWN Surface water 100'+ Wells on adjacent lots **95'+ COMMENTS **SEE ATTACHED WAIVER PACKAGE G, ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Prin}ied/Name Date ~/t5/02 N/^ ~"~ ,+ Driveway, parking/vehicle storage ~ JEFFREY A. GARNESS HAP, Fee $ ~ Date of Payment %' t I' (~v. 1~01) tO0.O - Waiver Fee $ · Date of Payment Receipt Number ~ mi L.07 3 LOT 1 AS -BUILT OF:. LEWL pfpT,pMt r _r.e.r.n OT Z BLOCK 4 440 BENSON / tos AtK1CRAM ALASKA 99503 562-59Wx i-6626LAND 4& CONSTOWMICALHAI.LA SUUlV1510 t'�2tYYAY 1062002 11PJ 2736 m lll� ye ebol LOT 2 x'49 -TO A LS-la%2 .= i • 1 • Gla: nlm'v. ` DON FOLLOWS t Ut • �iilGWft I AWVJ04 km e,r*eee • eb ow err I s:b - • y v vh ■ . Ise dFamifto e d 0777 flee i.permots U%oWo BOOM a bie Mbe Vmo �d y mmeadmamoM6 Yti O,O/ 0I e*Mo. 1 IM MOIL R In WO o~l P!r!nIRI Mo IIVA- a fM �s L911KT- mmoemoM< o+W101c W ,mbrs r an qnw � w GO""- • mobs-*• OWL 'MOL wew me ,i'musts"m *NNW dMle no OM.IbiY &m& be e#s Mn• 4=m&mc imo'r V e�y D*1I � 30.0' - S t y 470 ip,Z w , r- , m � u )'^ EXISTING w' ( j Lo HOUSE` O o t D 0. •> -` 'S �- Q 20.2 ...... '.GRAW"1 -- V 30.0. L.07 3 LOT 1 AS -BUILT OF:. LEWL pfpT,pMt r _r.e.r.n OT Z BLOCK 4 440 BENSON / tos AtK1CRAM ALASKA 99503 562-59Wx i-6626LAND 4& CONSTOWMICALHAI.LA SUUlV1510 t'�2tYYAY 1062002 11PJ 2736 m lll� ye ebol LOT 2 x'49 -TO A LS-la%2 .= i • 1 • Gla: nlm'v. ` DON FOLLOWS t Ut • �iilGWft I AWVJ04 km e,r*eee • eb ow err I s:b - — y v vh ■ . Ise dFamifto e d 0777 flee i.permots U%oWo BOOM ow bie Mbe Vmo �d y mmeadmamoM6 Yti O,O/ 0I e*Mo. 1 IM MOIL R In WO o~l P!r!nIRI Mo IIVA- a fM �s L911KT- mmoemoM< o+W101c W ,mbrs r an qnw � w GO""- • mobs-*• OWL 'MOL wew me ,i'musts"m *NNW dMle no OM.IbiY &m& be e#s Mn• 4=m&mc imo'r V e�y D*1I � FROM : ~ana$onlc TAD~FAX ,.F~HON~. NO. : ~07~454938 Jun. IT ~:~0~ 09:00AM P1 II II 11, 11 he moved equtp~en~ in ~ne over to Lot 2, ovned by gime fa~l~r. Well wGs drilled p[ior to conetruction of house and geptio~ Good water in. those day8 '~a~ ~b~portant,. I. oc~tlon of well, Minimum dtst&nce ree;ulrl refleCled In ~ther p~v]~lonl ~ ~l~ title Ih~ll be itrlctly -- ~hered tO. Wllll Ihlll bi pllcld ~ lets ~ thl~ ~e · .~e lot. Whe~ 4 lewe~ JyIt~ hal bHn I~s~lled off ,-- p~plrty prior ~ ~e Bppl;CItIOh for I groqnd ~ter we~l .. ~ ~l p~perty, ~t permit ippllflnC Ihlll not drill 4' ! ,:c,,,, ~. ,,~.~ s.'~I 17 11 FROM : Janasontc TAD/FAX PHOK~ NO. : 907J4549~8 Jun. l? 2~ 08:58AM P1 RTI'I L/' i "1 · o 4 I J 3 4 $ & II VE~A WEST' SEPTIR S¥STE~I LOT2. VA LHALLA Sub SCALE: 1 C~.iOf~ Municipality of Anchorage Mark Beglch, Mayor Building SM~ty Division I'.O. Box 196G50 * 4700 Bragaw Street Anchorage, Alaska 9(.)519-6650 · (907) 3/13-8301 · F,mx (907) 843-8200 httl)://www.nnmi.org 8/25/2003 JeffGamess, P.E. Alaska Water and Waste Water Consultants, Inc 3701 E. Tudor Road, Suite I01 Anchorage, Alaska 99507 Subject: Waiver Request for Valhalla Block 4 Lot 2 Waiver Request #WR030066 Parcel ID #015-211-03 HAA#030400 Dear Jeff Gamess: Your request for a waiver of the required 100 feet horizontal separation from the absorption field to private well on the subject property has been approved. The approved separation distance is 75.0 feet. This approved waiver also includes the 95' from the well on the subject property to the drainfield on Lot 3, Block 4, Valhalla S/D. And 95' from the well on Lot 12, Block 3, Valhalla S~D to the existing drainfield on the subject property. This waiver approval applies to the existing absorption field to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, -Site Water & Wastewater Program Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WRY: 030066 PID~: 015-211-03 HA#: 030400 Date Received: 8/25103 Legal Description: Valhalla SID. Lot 2, BIg~; 4 Engineer: Jeff Games~ Alaska Water Wastewater Consultants. In~; Applicant: Don Follows Permit: Waiver Requested: 75' from the well to the dratnfleld on the sublect orooertv. 95' from the well on thA sublect orooertv to the drainfleld on Lot 3. Block 4. Valhalla SID. And 95' from the well on Lot 12. Block 3. Valhalla S/D to the existino dralnfleld on the sublect orooerty, Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: Waiver is not Granted: List Conditions or Reasons for above: Name of Reviewer Rec#: 39927 Amount: $1000 Date Paid: 8125/2003 Is- ~.03 "' ~-~ = ' ~' ' / 8.'1 ~, A ASI(A WATER & WASTEWAT/ ER ~--' "- CONSULTANTS, INC. June 30, 2003 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Waiver Request and Health Authority Approval for Valhalla Subdivision; Lot 2, Block 4, The existing 3 bedroom house is served by a private well and septic system. During our site evaluation for the purpose of obtaining a Health Authority Approval we identified the following encroachments: · 95 feet from the well on the subject property to the drainfield on Lot 3, Block 4, Valhalla Subdivision. · 75 feet from the well to the drainfield on the subject property. · 95 feet from the well on Lot 12, Block 3, Valhalla Subdivision to the existing drainfield on the subject property. We are requesting waivers for these encroachments based upon the following facts: · The septic system on Lot 3, Block 4, is uphill from the referenced well. The lot is graded so if the septic system was to overflow, it appears that the effluent would not travel toward the well head. · The septic system on the referenced property is at a lower elevation then the well head on Lot 12, Block 3. The well head is built up and landscaped around it so as if the septic system was to overflow, it appears that the effluent would not travel toward the xvell head. · The location of the septic systems on Lot 3, Block 4, and Lot 2, Block 4, Valhalla S/D are in a very visible area so that if any effluent was to surface, it would be noticed and the problem corrected. The other path of contamination is subsurface migration of the wastewater. As can be seen on the attached well logs, the average depths of the wells range from 92-218 feet deep. The average static water levels vary from 96-110 feet, which is an indication that the water table is confined below the overlying soil stratas. Based upon recent water sample results it appears that the insitu layers of sandy gravel, clay and hardpan soils have served to inhibit the migration of untreated wastewater into the aquifer. Recent water samples on Lot 2, Block 4, indicated Nitrate levels of 0.1mg/L and no bacteria. Recent sampling from the well on Lot 12, Block 3, had nitrate levels of 0.301 mg/L and no bacteria. Based upon the aforementioned facts, it appears that there is minimal risk associated with granting the requested waivers. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com We also request a 0 foot lot line waiver from the existing drainfield 'to the west lot line. The actual driving surface of the road is approximately 15 feet from the existing drainfield. The septic system is in the road right-of-way and there are no septic systems within 50 feet from the drainfield. It appears that there is minimal risk associated with the granting of the waiver. We are currently obtaining a letter of non-objection from M.O.A. public works for the septic system encroachment. Onc ~ we obtain the letter of non-objection we will forward a copy to your office. ~stions, please contact us at 337-6179. Thank you for your assistance. '.E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com - / / ' / ~.~. i!l I j ~; / / LOT ;3. BLDCK 4. ,' · / w~,~J.X S/D; / '~ ~, [ ,'-' / X ~ // ..... / ........ ~ ! \ ^// ! / /1'~5 ~ I, \l 1---~_._4 ~ ' ~'-------,'~-~--~-- -- --- ~. , II "~ I I/ ' X / NOTE: THE ~ ... .~ . ,~ . ,,, 6/50/2005 ...... ~ CONSULTA~S, INC. - ..... DON FOLLOWS 545-4958 2 OF 2 VALH/~U * SUBDIVISION; LOT 2, BLOCK 4, .'"' ' D~AIL DRAWING FOR WAIVER PACKAGE