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HomeMy WebLinkAboutVALHALLA #1 BLK 4 LT 7 Municipality of Anchorage Page 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: .~ C,,..} ~'700~ ~t'~ PID Number: (~) Name: ~/[:~SY ~ WL,¢2~ Wastewater System: D New ~Upgrade Address: I~t~F5 ~,v~F~ ~p, /{~r~ ~ ?~51~ ABSORPTION FIELD Phone: '~)~5"~ I No. of B~ooms: ~Deep Trench ~ Shallow Trench D Bed ~ Mound ~ Other Total Depth from original grade: LEGAL DESCRIPTION S°JlRating: O,~ GPD/Sq. Ft, Lot: Block: ~/ Subdiv~ion: Depth to p~e bottom from riginal grade: Gravel depth beneath pipe /~./~/.~ ~ z/~ -, ~t. ~,5 ~t. Township: .......IJ Range: Section: ~ Fill added above/.~original grade: Ft. Gravel lenglh: ~ t Ft. , Number ~f lines: ~ Distanc~ b_etween ~ines: WELL: ~ U New ~ Upgrade ~ ~ra~.~width: ~ -~ Ft. Fh Classification~ ~['~ ~ 't(Private'~ A.B.C): .~'~-T°tal~-~D~h~~'Ft. Cased To: Ft. Total absorptions7~Oarea: ~ SO. Ft. Driller: ~-/¢ Date Drilled; StaticWaterLevel: Instal:., ~o~¢ ~¢/~'6ff~ Dateinstailed~ SEPARATION DISTANCES ~eptic D Holding ~ S.T.E.P. From Tank Field Station Tank Sawer Lines~[~ ~.j , ~ ~ ~ ~ ) ) LIFT STATION Water ~0~ ~00~ ~LineE°t JO t.~ ~ I~~ ~ ~ Size in gallons: Manufacturer: Foundatio~ JO ~ [ ~l~ ) --~ "Pump on" level at; ~~1~ High water alarm at: Remarks: ~,~7,~c- 'l-~,v~ P~,.,~,g~ BENCH MARK Inspections performed by: ... ~,,~,NE,m,.~ Dates: 1st. ~'"5 ~ 17034 E.gle River Loop Read, NO,~ 2nd & -G - ~ ~ ~ ~,~ c, cowA~ '~j Department of Healt~ and Human Services approval Reviewed and approved by: Date: ~-2~-¢ 7 72-013 {Rev 9/91) MOA 25 PgRMI'i' NO. SW970065 PAGE 2 O]~ 2 Nlunicipo[ily oF Anchoro. ge DEPARTHENT OF HEALTH AND HUHAN SERVICES ENVIRONHENTAL SERVICES D~VISION P,B. Box 196650¢ Anchoco. ge, Ato, sko 99519--6,650,~Tetephone: 343 4744 ON-SITE WASTEWATER DISPOSAL SYSTEf'I AND/OR WELL INSPECTION REPORT ],[:GAL LOT 7, BLOCK 4, VALHALLA SUBDIVISION P.I.D. NO. 015--211--08 A B sC¢1 6,5.0' 46.0' 7,3.5' 53.5' IST2 80.0' 59.0' ~ 82.5' 61.0' IDBL 82.5' 61.5' IC01 65.0' 64.5' tMT1 65.5' 64.0' fc02 ~07.0' 84.5' IMT2 105.0' 8,5.0' __ _/93,3' COl .,//I /// ~/ ~ ~' %NEw ooo SEPTIC TANK ~-NEW TRENCH FINAL GRADE MT CO FINAl. GRADE~__~ MTi = 81.3'~///~ MT2 = 81.4' C01 = 91.7' ¢///~C02 = 91.8' hCO1 = 87.9' C02 87.7' A NO WATER FOUND 76.3' B.0.H. PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASRA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970065 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:TAYLOR KIRBY M & OWNER ADDRESS:12125 WILDERNESS RD ANCHORAGE, ALASICA 99516 DATE ISSUED: 4/18/97 EXPIRATION DATE: 4/18/98 PARCEL ID:01521108 LEGAL DESCRIPTION: VALHALLA ~1 BLK 4 LT 7 LOT SIZE: 16855 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION 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 {18A3%C72) 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 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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 SANE DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: DATE: // PAGE 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:SW960017 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:TAYLOR KIRBY M & OWNER ADDRESS:12125 WILDERNESS RD ANCHORAGE, ALASKA 99516 DATE ISSUED: 2/01/96 EXPIRATION DATE: PARCEL ID:01521108 LEGAL DESCRIPTION: VALHALLA #1 BLK 4 LT 7 LOT SIZE: 16855 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. 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 (iSAACS0) . THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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 THE FOLLOWING SPECIAL PROVISIONS. 1 OF 2/01/97 SPECIAL, PROVISIONS RECEIVED BY: ~ DATE ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. SEWER&WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAl & MECHANICAL INSPECTIONS January 16, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 7, Block 4, Valhalla S/D Request you issue a permit to upgrade %he septic system servin9 the three bedroom house on the referenced property. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. At the time of excavation no water was encountered in the test hole and after seven day ground water monitoring, the monitoring tube was found to be dry. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. The proposed 1000 gallon septic tank is to be placed outside the well protective radius. Attached is a site plan which depicts the location of the proposed tank. If you require additional information, please contact us. Sincerely, Robert C. Cowan, RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP . SUITE 204 ° EAGLE RIVER, ALASKA 99577 "= 5cr~. I DESIGN UPGRADE SCALE ~ I ~ ' O~ 0 Z WILDERNESS ROAD ~ "x... .) / t- O ~ 100' R'AD1US [00' WELL I~AD[US 10' UTILITY EASEMENT :....:.. ....... ~,.,. ~,,, !:- ',-" ~ ,~'"NN '" '7 ~ ,, ~ .'-" o "~xr'%. % ..', ~ '~, <t,.",, ; / ~ ,: ~ 3Z W~LDERNESS ROAD o~mO ×$~ \ ° }-7 : n Municipalily of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, ARchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: I© ~?)'"/ ~' /} YLO'/~ DATE PERFORMEr LEGAL DESCRIPTION: LO 7- 7 ~L~' ~/ V/Ict/..?c,-,:~ J~"¢Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT __ DEPTH? Daplh Io Water After ~oni ormg? Gross Net Dep(h to Net Reading Date Time Time Water D~ op -- r~ --;~ ' ~'- u -- ~ %" - -'- ...... ~..LY- ~' ~ ~'- ~"~ 6 '1,~ " ~/~ ~' 'l ,: ~ ~ -- 6 ~1~ "__ ~ .__~' : ~ s'- ~ '1,," PERCOLA1 ION RATE 1 ES'I RUN BETWEEN ByS & S ENGINEEEING 17034 Eagle River Leop Road No. :~04 ~.. ACCORDANCE V~OAI/~I~.SI~.,I~I~C'~&I~IC~C~PAI. GUIDELINES IN EFI'ECI ON Tills DATE . CERIlFY 1HA'I THIS TEST WAS PERFORMED IN DATE ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. ENGINEERING STUDIES AND REPORTS WELt. INSPECTION & FLOWTEST StTE pLANS ROAD DESIGN $OILTEST STRUCTURAL& MECHANICAl INSPECTtONS REFERENCE: GENERAL: 1. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Lot 7, Block 4, Valhalla S~D January 16, 1996 3e The scope of this project includes the installation of a 1000 gallon septic tank and a leachfield trench to serve the three bedroom residence located on the referenced property. The existing 1000 gallon septic tank is to be excavated, pumped, crushed, and abondoned completely. The existing leachfield is to be abondoned such that it may be used in the future. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 7034 NORTH EAGLE RIVER LOOP · SUITE 204 ' EAGLE RIVER, ALASKA 99577 Page Two Lot 7, Block 4, Valhalla S~D January 16, 1996 Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cteanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 7, Block 4, Valhalla S~D January 16, 1996 Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 7, Block 4, Valhalla S~D January 16, 1996 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be baekfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 7, Block 4, Valhalla S~D January 16, 1996 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to 'this project. CONTRACTOR/INSTALLER Hea ~UNICIPALITY OF ANCHORAGE t and Environmental Prote¢ on Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON~SI'I'E SEWAGE DISPOSAL SEPTIC YANK: Oi¢]ANCE '~ x . NUMBER OF ~' /~ MAf~iUFACI'URER ~~_ MATERIAL~% ...... COMPARTMENTS %-' [ < ."~--/ '3.~ [ TOTAL LENGT~ / ~ O~ ~GS . _~ .... DISTANCE BE]WEEN LIf4E5 ~ ~TREhlCH '¢¢IDT~IN. TOTAL EFFECTIVE DEPT~t ]Ot OF 1ILl 30 [IhllSIt ORADE ~( MA[ERInL ISENEATII 'IILE '/~'~ IN ABOVE TILE _~ IN.~ 5EEPAGL PiT: Log Crib Rings Crib Size: DIAME1 Elt___UEPYH.__ DISTANCE FROM: WELL TOTAL_ EFFECTIVE NEARES~ LOT LINE .... ABSORPTION AREA WALL_ AREA) .SQ. Fl'. Well ~6c6(~ Class: DepLh: Well Distance To: Lot Line Bldg: ,~.~ I -,2) _ Sewer Line: __ Pipe Materials: # of Bedrooms: __~.~ Install. er: . /7 _[ i~ ~ ~ :d:! ii! i'::. [I[: ]'ili,![i'iiiFi i:'i l"lli i:lP[i','[:, ili: Ii,ii: i [',! I [il!ii:I:[! i i i ~i:;::,~!i; '1 i:()l' :;"?::i[ !'i l!i'H),'~i!': ,'1[I[ i'[F['~' ][]i: '::;iii:: ii:! 'i ii~ :,1:, ': : i[l[,i (ili'i! [':: ,:[ :!i[![::i::i'ii::l',!1:, ['iii'~ i:!!:~i:'i iF ::J:'i:C:[[ I(:i:i! :i[l:~i'.i::; !::iF,Ii::' ::(i!.,]::;ii::ii~: I i i::'i[:iiiFi:[ii'i:, ! :i: Lot 7, Block Valhalla Subdivi !;] on Add] tion 1 60 ' / Not To Scale. Distances shown are approximate and have not been measured by surveying methods. I,OG OF TEST HOLE NO. 1 ale: ] "= ORGAHIC NATERIAL SILTY SAND W/SOME Gf~¥'/R,(SH) BroWn, s~ight]y Moist SANDY SILT W/SOHR ';~ C GFO\','NL W/SOHE SILT AND SAHD 2~ois t:, Grey ] 5. ') ' 17.0' SILT W/SOHE SAND Noist, Grey This loq depicts subsurface soil!; observed withia the test hole git See DrawSnqs B--OI and B-02 for planation of symbols. CKD: fi~tI~ J 11 I:I&M CONSUL:rANTS, INC. DATE'6 10 77 -ill .................................. SCALE,~ee~?pV~L__ -- - - IX3CA'i'f ON SKETCll AND TI']ST llOI,E LOG DICK THONP$ON June 13, 1977 R&M No. 75] 171 Dick Thompson SRA Box 4103-A Anchorage, Alaska 99502 Subject: Soil Investigation for Sanitary Sewer System, Lot 7, Block Valhalla Subdivision, Addition ~1, Anchorage, Alaska Dear Mr. Thompson: At your request of ,June 8, 1977, we conducted a subsurface soils invest[. gation at the proposed location of the sanitary sewer system eli the subject lot. the investigation complied with those procedures required by the Municipality of Ancborage Department of Health and Environmental Protection. This investigation, ~ich was accomplished on June 9, 1977, consisted of a test hole drilled to a depth of 20 feet below the existing ground surface. The test hole was sited according to your instructions and its location is shown in attached Drawing A-01. Drilling was accomplished with a rotary drill rig using continuous-flight, solid-stem auger with an outside diameter of 6 inches. A sample was taken at the depth shown on the soils log in Drawing A-01. The sample will be held in storage at our lab for approximately six months. In addition, all material brought to the surface by the augers was continuously monitored by an experienced engineering geologist. The topography at the drilling site is generally horizontal.. At ti~e time of the investigation the site had original vegetation consisting of spruce forest & low brush. The top of the test hole was located al: original ground surface. The soils encountered in the bore hole are shown in the test ho]e log in Drawing A-01. The symbols used in Drawing A-01 are explained in Drawings B-01 and B-02. This log displays specific conditions encountered at the test location. However, subsurface conditions may vary in other parts of the lot without any apparent surficial evidence of the change. Groundwater was not encountered. Bedrock was not encountered. At the time the hole was drilled seasonal frost was not present. A percolation test was performed within the bore hole at the depth shown in the attached 'Fable 1. All depths were measured from the top of the hole. The data in Table 1 show average infiltration from the depths indicate_d~ t_o_ the bottom of the hole. The measured percolation rate wes 2.66 minutes per inch.' June ].3, 1977 Mr. Thompson Page -2- We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this letter or if we can be of addJ. tional service. Very truly yours, R & M CONSULTANTS, INC. S tephanie Hoag Staff Geologist Jim McCaslin Brown PhD. Head, Earth Science Department SH:J~/gld Attachments: Drawings A-01, B-01, B--02, Table 1 XC: Department of Hea].th & Environmental · ' i completed .............. , :.: ................................................ Depm ot well ~:.. ~:,, ./ , vzac~ while pumping · ~ ............ OJ~ ~]:((.-.: ....................... gallons per hour. Formation .... :._~" :...n_ _,..2 ~.. , /~; .... , :-j..-,., ., ...~, , ~-- , .': '. - .-/ . _,-~. ~ ..... . - .... ~. ~_-.~, :~ Driller t~¥ 0~: ANc~O~-AG~: MUNICIPALITY OF ANCHORAGE ~NtC~AL . ,-:[',/iCES 01',/1510~ DEPARTMENT OF HEALTH & HUMAN SERVICES E,R, Vt~.oHMEN'fk"- ~'- DIVISION OF ENVIRONMENTAL SERVICES F ~ ~' 7 ~O~'TCERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL r/-/~)~* ~'{-..~ OF ON-SITE SEWER AND WATER FACILITY Application Date P7/¢//~7 GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (incLude lot, block, subdivision, section, tgwnship, range) LC) F Location (address or directions) (b) Prope~y Owner ~¢~ ~; ~¢~ Telephone: Ho~e Mailing Address ~ ~ ¢~ ~ ~ (c) Lending Institution ~ ~ Telephone Mailing Address ~,~ ~ ~ /O~ ~~ (d) Real Estate Company and Agent ~v~ ~t'~/~ ~ Address ~ ~¢~% Telephone ~ ~% / (e) Mail the HAA to the followina address: or: Check here ~ if hold for pick up. List contact person and day phone number below. Business ~'~ -2-7~, / TYPE OF RESIDENCE Single-Family'~ Number of Bedrooms __ WATER SUPPLY Individual Well/~ Community I-1 Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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 the legality and status. Page 1 of 2 77-025 IRev 8'861 Fronl leUO!l!puo3 le^o]dd¥ leUO!~!puoC) ,to SLUJal po^oJddes!C] ~ pa^oJddV Xq sLuooJpeq ~ Joj po^oJddv "I'~AO ~ddV SHHO '9 leOS s,Joeu!6u~ '9 CHECKLIST - FEBRUARY 1984 WELL DATA Well Classification Well Log Present (Y/N) Total Depth ~ c~ 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 a~-~7~- Yield ZO ~ ~__~ Cased to /~ Depth of Grouting ~ Pump Set At ~ ~TO ~ Sanitary Seal on Casing (Y/N) ~ Depression Around Wellhead (Y/N) j /_o~ ; On Adjoining Lots /O~ + To Nearest Edge of Absorption Field on Lot ! ~O ; On Adjoining Lots To Nearest Public Sewer Line ~{'-[~--- __ To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by Water Sample Test Results ~ D~ ~--- To Nearest Sewer Service Line on Lot ~ / C> ~' ~ ; Date __~"/~"~'/~ '7 B. SEPTiC/HOLDING TANK DATA Date Installed ~l°/tc~/'7 '7 Standpipes (Y/N) ~1~-~' Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) 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 Air-tight Caps (Y/N) Size I ~ No. of Compartments '~'/'~__ Foundation Cleanput(Y/N) Date Last Pumped ; for N/'.~ Temporary Holding Tank Permit (Y/N) //9 To Building Foundation ~'~ To Disposal Field ~ To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata I ¢2-o Date Installed I c~.//~/'2 '? Width of Field ~' '~ Type of System Design Length of Field -~/~ Depth of Field I ~ Gravel Bed Thickness 6 ° Standpipes Present (Y/N) '~' Date of Last Adequacy Test _ ~,/'~/~./& 7 Square Feet of Absorption Area -~/,.~ Depression over Field (Y/N) Results of Lest Adequacy Test Separation Distance from Absorption Field: h¢ o/v'A-F To Water-Supply Well _ 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 To Property Line .>! To Existing or Abandoned System on ; On Adjoining Lots ~ ~ To Cutbank (if present) __ Comments Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at _ Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** Is~rntief~ that I~ch~~f~ratrreed to ~//M~O/.Aga;d HAA guidelines in effect on the date of this inspection. Company __ MOA No. Receipt No. ¢~. O O / - O O / '~ Date of Payment ~ --/ "~ -- ~"7 Amount: $ / 0 0 o o Page 2 of 2 72-026 (11/84) Engineer's Seal CONStJL'I~NQ [ NGIN~I~I~_ .......... TFI EPHONE: (907) 279 39~6 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O.BOX 6-6650 ANCHORAGE, ALASKA 99502-0650 MARCH 3, 1987 Subject: Lot 7, Block 4, Valhalla Subdivision. Gentlemen; Per your letter of February 18, 1987, we drilled a monitoring well as instructed on subject lot on February 19th. The hole was located 10 feet from the trench and was 15 feet deep. The materials encountered consisted of silty sand and silt. No free water was encountered during drilling. A 1-inch slotted PVC pipe was installed in the hole, and the hole was plugged with soil. On March 2, 1987, the hole was inspected. No water was observed. The conclusion to be drawn from this observation is that groundwater is not present within 15 feet of ground surface at this time. Yours unicip litYof Anchorage P.O. E,~X 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONYKNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES February 18, 1987 Tobben Spurkland 203 West 15th Ave. C suite 203 Anchorage, Alaska 99501 LOT 7 BLK 4 Valhalla Subdivision Mr. Spurkland, Please let this letter serve as confirmation of our conversation of February 17, 1987. As discussed this department will require the installation of a monitoring tube on the subject lot. Placement of the monitoring tube should be such that the tube is parallel to the axis of the trench and not more than 20' from the distribution pipe. The tube shall be of sufficient depth to verify proper ground water separation and shall be monitored for a period of at least 7 days. Upon verification of the presence or absence of ground water a Health Authority Approval may be issued. Thank you for your cooperation in this matter. Daniel N. Bolles Eng. Tech. III DHHS ANCI!(![ A[;E ALASKA 99501 CONSULTING ENGINEER TELEPI~ONE 1907) 279 3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: LOT 7 BLOCK 4 , VALHALLA -J~'~" O¥"' ~/'~'~ 12125 WILDERNES DRIVE SINGLE FAMILY, THREE BEDROOMS PRIVATE, ON SITE FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 312 SQ. SOIL RATING: 100 INSTALLATION DATE: 1000 GAL. FT. OCTOBER 1977 DATE OF PUMPING: FEBRUARY 14, 1987. ANCHORAGE CESSPOOL PUMPING DATE OF TEST: FEBRUARY 12, 1987 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH 4.5 FEET OF COVER AND 47 INCHES OF LIQUID. TRENCH CLEAN OUT WAS FIVE FEET DEEP AND WITH 2 INCHES OF LIQUID. 6-INCH SUMP WAS 10 FEET DEEP AND HAD 67 INCHES OF LIQUID. WATER WAS ADDED TO THE TRENCH CLEAN OUT WHILE THE WATER LEVELS IN THE TANK, AND SUMP WERE MONITORED. A TOTAL OF 500 GALLONS WERE ADDED. THE WATER LEVELS DID NOT CHANGE. THE END OF TIlE DISTRIBUTION PIPE COULD BE SEEN IN THE SUMP APPROXIMATELY 12" ABOVE THE WATER LEVEL TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. ~ ~ ANCHORAGE, ALASKA CONSULTING ENGINEER TELEPHONE (907) 279 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: TYPE OF WELL: WELL LOG AVAILABLE: INSTALLATION REQUIREMENTS MET: LOT 7, BLOCK 4, VALHALLA 12125 WILDERNESS DRIVE DAVE MILOT SINGLE FAMILY YES YES WELL YIELD FROM WELL LOG: 8 GALLONS PER MINUTE PUMP YIELD: 6 GALLONS PER MINUTE TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 6 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE DRAWDOWN STABILIZED. STATIC WATER LEVEL WAS FOUND AT 82 FEET BELOW TOP OF CASING. AFTER TEN MINUTES THE WATER LEVEL WAS 87 FEET THE WATER LEVEL STAYED AT THIS LEVEL FOR 50 MORE MINUTES. WELL RECOVERED 100% IN THREE MINUTES AFTER PUMP SHUT DOWN. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON FEBRUARY 13, 1987. TEST WAS NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. THIS WELL WILL PRODUCE MORE THAN 6 GALLONS PER MINUTE FOR MORE THAN FOUR HOURS The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. MUNICIPALITY OF ANCHORAGE DEPT. ©;: [; ,.ld &  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC'~RONMLN~AI' 825 L Street - Anchorage, Alaska 99501 ,~UN ENVIRONMENTAL ENGINEERING DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not he processed. Please allow ten (10) days for processing, PROPERTY OWNER PHONE MAILING ADDRESS · PROPERTY RESIDENT (If different ~rom ab~ove) 2, BUYER PHONE PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE h :' A"/-, MAILING ADDRESS 4, REALTOR/AGENT PH~)r,J E MAILING ADDRESS~ , /C / r-~. 'LEGAL DESCRIPTION STREET LOCATION ~, TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ One ~ Four ~ SINGLE FAMILY ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six [] Other 7, WAT RSUPPLV · ~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY * ATTACH WELL LOG. A well log is required for all walls drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) ~,.~,'~ ~/~ ~ S. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, ~2-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DAT~ DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [~ THREE ~ FIVE E~ OTHER I~ MULTIPLE FAMILY [] TWO [] FOUR [] SIX '1~ ERMIT NUMBER 2. WATER SUPPLY E~] INDIVIDUAL DEPTlt OF WELL I~ COMMUNITY DATE DRILLED [~ PUBLIC UTILITY Connection Verified LOG-RECEIVED 3, SEWAGE DISPOSAL SYSTEM -~'ERMIT NUMBER E~] iNDIVIDUAL/ON -SITE DATE INSTALLED []puBuc UTU T¥ Connection Verified INSTALLER []Septic T~k or [~ Holding Tank Size: ~I~ if Tank is homemade SOILS RATING give dimensions:_ TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Septic/Holding, Ta~k IAbsorption Area Sewer Line Nearest Lot Line D STANCESwELL TO: '¥r Absorption Area to nearest Lot Line 5. COMMENTS [~ 12ONDITIONAL APPROVAL (letter most accompany certifi~te~ [] DISAPPROVED LEGAL DESCRIPTION 72-010 (Rev, 3/78) #l: Time Date Insp 'UNICIPALITY OF ANCHORAGE DEPARTMENT JF HEALTH AND. ENVIRONMENTAL  825 L Street, Anchorage. Alaska ~i' j' 264-4720 ~J Date Received: 3ROTECTION 99501 October 5, 1977 9:00 am. #2: Time ~3: 10-10-77 Monday Date Willis Insp Time Date Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: National Bank of Alaska Mailing Address: Post Office Box 3-3859 Phone: 279-2506 344-8635 2. Property Owner: Mailing Address: Dick K. Thompson Phone: Star Route A Box 1690A 99507 3. Legal Description: Lot 7 Block 4 Valhalla Subdivision 4: Single Family Residence: (x) Number of Bedrooms: Multiple'Family Residence: ( ) Number of Bedrooms: Three Well System: Individual Well (x) Community/Public System (x) Permit ~ ~ / Depth of Well 109' Well Log on File Construetio= Baoterial Analysis Sewage Disposal System: On-site System (x) Public Utility ( ) Permit # ~~ Installed 1977 Installer ~ Septic Tank Size ~l~ Manufacturer ~~ Absorption Area ~OF_~ Soils Rate ~ Material ~ Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line Page Two Department of Request for Approval Health and Environmental Protection of Individual Sewer and Water Facilities Legal Description: Lot 7 Block 4 Valhalla Subdivision Co~raents: Affadavit Attached: ( ) Letter Attached: ( ) Approved: ~ ~ ~ Date: Date: Disapproved: Department Worksheet: MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protectio~ ' ' ' ~/Request for Approval of Individual Sewer and Water Faciliti~'~ 2. Name of Buyer: Phone: Mailing Address: Phone: Lending Institution: /~. p. Phone: 276/-250~/ Realtor/Agent: Mailing Address: Legal Description: Street Location: Single Family Residence: Multiple Family Residence: Phone: Number of Bedrooms: ) Number of Bedrooms: Water Supply: *Individual Well (~ Public/Con. unity System If Individual Well, well depth __JOy/ If Community System, name of system ( ) Sewage Disposal System: On-site System (~ Public System ( ) If On-site System, date of installation: ~ EPT__21) *NOTE: A well log is required on ALL wells drilled since 6/75. 3/77