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VALHALLA #1 BLK 4 LT 10
Valhalla # 1 Lot 10 Block 4 #015-211-11 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-~650 www.oLanchorage.ak, us (g07) 343-4744 Permit Number: ~'V~/ o00 ~--~- Page j of ~ ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PIDNumber: 0~'-~ ~-//- ]/ Wastewater System: [] New ~'Upgrade ABSORPTION FIELD LEGAL DESCRIPTION [] New Well: SEPARATION DISTANCES TANK [] Other: Septic [] Holding [] S.T.E.P Septic Absorl~o~ Lift Holding Tank Field Station Tank Sewer Line r~.$7- ,~'~,~o r~ Engineer's Stamp ~ ......... ~¢~,,,, ~..' A '..~ ,,, ~' n ' , ~** " . h . / ..... " ~3~ Department of Health and Human Services approval .ev,ewed and ap.roved ~y: /).~/~ ~ ~/. /~Y-- Date: 4 ,,,,..,,,,, ,/-//- / LIFT STATION BENCH MARK Inspections pertonnedby: .~.~,5~,J /v~o~/(..~ET~- Dates: d / / / / MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Apr 25, 2000 Expiration Date: Apr 25, 2001 Permit Number: SW000075 Legal Description: VALHALLA#1 BLK 4 LT 10 Design Engineer: 0819 Jason Moncrieff Owner Name: William & Hollis Rinehad Owner Address: 12035 Wilderness Rd. Anchorage, AK 99516- Parcel ID: 015-211-11 Site Address: 012035 WILDERNESS RD Lot Size: 16012 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: WILDERNESS ~D. MUNICIPALITY OF ANCHORAGE DE\~RTMENT OF HEALTH AND HUMAN Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES · ~i~,(..~ ~) ~ ~~ Tn SEPTIC ABSORPTION Ad~,~ ~ FROM~ TANK FIELD WELL Phonets, ~ ~7~2 Permit~oNo No o' drooms W"LL SubdiwsioD ] / . ~ 5~2 '~/~ ~ K3 ~ drive,Ag-[ UILT DIAG.A. tahow,ooat,on o, ~e,e sepUc system, propertyf,nes, ,ounoat,on,,ay. water bodies, etc TANKS SEPTIC ~ HOLDING C~pac, ty ,n gallons TYPE OF SYSTEM ~TRENCH ~BED ~ W. DRAIN ~ OTHER Total absorption areal 0~ S~ FT Distance betwee~ li~es~ I ~T ~/ ~ FT ' ' :1 7 Municipal and State guidelines in fllect on this date: 72-073 (3185) / l>,)e !l MUNICIPALITY OF ANCHORAG'~' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3- · ' SLOPE 7 8 9- 10- 11 12 13- 14 15 16- 17 18- 19- 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT )EPTH? DATE PERFORMED: SITE PLAN ~,, ~,, ~'~r,~ __'4' _ FT *ND 4-YZ FT TEST RUN BETWEEN F._EH~ r No. RF'F'L ]: CFINT L O E: Ft T I Iii N LEGFiL ,:,H.F' - F,,.E., '-- Rla'" - £:,Fi ',/' ! L:; '_:_-: R FI E,' -'"_ ,. ~-- -' '" T HIL.DERNESL:; LFINE LL3T 10 E:LK 4 'v'FILHFILLF! :E;,-."D T'T'PE OF' :~ ] I L, FIE:SEIRF"T ! Cl~",i S'T':E;"FEf'! ! 'Z;: 'I-F;:Ef-,ICH ',IA':.:;Tf,1 ........ f" N MEFF' OF E',EDF~%.3f'I~; = ..;.? , [ 2!:];E, Eu3 ?:;C!LIRF:E: F'EE'!I -" :::['1" I NG ,:iL: F I',-'"E:R ) ::: 16!3 -I'HE REI;!U I RE[:' S I ZE ElF 'I"FIE :50 ]: L_ FIE::E 'THE LENGTH DIHEi".4SION THE DEPTH OF R TRENC:H OR GROUND laN[;, THE E:OTTOf'I OF THERE :IS t-,lO SET HIDTH FOR TF -[HE GF.:Ff,/EL. DEPTH I5 'TI4E laND THE BOTTOH OF THE E',:.:;CFI',/R7 PEF::f,i!T RF'F1,L] C:Rf,,I-f' HF!F:: 'THE '_rf.4'E;TFiLI_FI-FI'Cd' li,,t'~:qF'EE:T'!Ed',P_{-; OF f.,!, If,IErER E g I [:,ENC:E~B THR'F -I'HE: .......... -F' [3F:IC:KF ILI._ I NG [:,EFIFIRT!"tEi'.tT I,.I I [ H I N I f,lLIH C,I S]"FIN~ .l.E,3 FEET FOR R I.!F'Ol',f THE 7%-'F'E O H I N I f'lUf'l E:,Z! TO FI COf'If'lUf.,I I T'./ ,C "J:-:: 7. % _F' E:E] 'SIJE]EC:T TO E:ETHEEN FI HELL. \,'FITE i.,fELL OF: F'U£3LI C 14E'L.L. F'F:OPI FI F:'F: l 'v'FITE L:[F,IE I5; 75 r,N ~ Fff',E:' ,a ,, OP:: [:,RFI ! i'-,!F' :[ EL.E:,. ?'HE Fi:: L F'ZF:'E THZ~; [:,EPRF;'.Tf'!E:NT DURING THE ~ TFI'!:E; PROPERT? RNE:, THE 5!TE SEHF!EiE [:,!'5F'fZ:i~-,FIL :'};"r'~:;TEH !'E; FEET' F'Fo3H FI F'LIE:L lC HELL. ['EPEND:[fJC4 f-F:.r.,H, :. :SEF.!EF: [... :[ i'-4E: IS t,LL..L T't Fi ...... f'- -,.- ...... r"-r F'IEET. CERTI F'T' THFIT ..................... ~ I..J% 3f,!--':~;(T[:' ':;~:'J.,JF;[("::; ¢i-I: .'.[-:.L.[ ':, [:I';~; ! FIH F'Fff'IILIFIF.: I-,.IITPt THE F'P':~ IF.?EHF'~'.J-F'n: :"-'-' ............. .,,- ! F Z F'TH E:'T' THE hll,.If-,I ! C: l F'FIL l T'T' Cd.:' i:ff-,fCHF)R FIG .{' 2: I HILL IN:STF!LL THE 3:: I UNDER':.'5, TFII",I[:' THRT THE ON-~.,ITE :~_-.;EI,.IEf4: ?./':2' E:!' hll::f'r' f:::EC¢._I:[F:E E',;I_::PqEr'E'"~-" IF -ri-.IE F~F--.,TF-F;~Ii-'F Ic F'E'M~F'ELE'r', TT~. T"-' ',F I"IOFE Tl--:h, 3 BE[::,RCu3Pb3. ,::,,=.,. x, x, FiF'PL I I~li'.4't- E:F!F.E,F!RFI DR ,,, :[ ?., Department 3330°f EnvironmentaIc Street Quality Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /~.r~'/,/~ 7-,,-J .~'~E~-¢ ~- MAILING ADDRESS /~ ~' z~/,~ ,.~'7--~E-L Z_,,¢ ~/4/ PHONE LOCATION LEGAL DESCRIPTION SEPTIC TANK: -~i: J DISTANCE / /':P/'/ '7~'~Z NUMBER OF FROM WELL //g) MANUFACTURER ~'~"~z. MATERIA[ INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /'~¢19 GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER OR WIDTH LENGTH DEPTH ~-/"/~' /~k' ,~4/ ~ /~ . LINING MATERIAL~/42~75 /'C~7/~'/CRIB SIZE: DIAMETER__DEPTH ~ / , DISTANCE FROM: WELL BUILDING FOUNDATION /~/, NEAREST LOT LINE ~/'J- TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) Z,./¢~ SQ. FT. ADDITIONAL ABSORPTION z./-~,-Z~7,~2,o /~..s'/~ ~$.~ WELL: ? , TYPE ~,--'7"~/t/O,' d, CONSTRUCTION /~¢¢~',¢¢'~'--,¢' DEPTH / /?'F'¢~ DISTANCE FROM: BUILDING /,¢" NEAREST ¢. NEAREST SEPTIC SEEPAGE FOUNDATION ~-o LOT LINE /o ! SEWER LINE TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED¢' DISAPPROVED REMARKS DISTANCES: INSTALLED BY: ~'gL¢ PIPE MATERIAl. ~/~ST" ~-~<P~/ LOT SLOPE: REMARKS: ~'z~ I/..)L~-.~' ,,~ o~c7~..-~-7~' ~f= '7",4~(~. DIAGRAM OF SYSTEM - DATE '-~/'~/¢':'~ APPROVED ,.~/--~:~*~ ~. ~-~¢~-/'~"~ G.A.A.B. Form No. EQ-031 GrEATEr ANCHORAGE ArEA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C"STREET ANCHORAGE, ALASKA 99503 PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT / ., DRAIN FIELD OTHER FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS ~'/'~~~ NOTE: THIS PERMIT IS NOT VALID WITHOUT LOll FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WELL BE SUBJECT TO PROSECUTION. SEPTIC TANK S]ZF~ ~ ' MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK SEPTIC TANK TO SEEPAGE Pit WALL SEPTIC TANK , SEEPAGE PIT TO NEAREST LOT LINE. DRAIN FIELD DRAIN FIELD SEPT,C TANK, //2/2' SEEPAge P'T TO RIVER, LAKE· STREAN. DRAIN FIELD · SEEPAGE PIT '/~ CAST IRON iNTO AND OUT OF SEPTIC TANK AND iNTO CRiB CROSSING GAP OF EXCAVATION 5 FEET INTO UND]STURBED SOil. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS· GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DIAGRAM OF SYSTEM ,F I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER AN O ~E AR B ~ E NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. k~x~ GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAl QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # Performed For Legal Description: Lot 10 Block This Form Reports Soils Log X - Soil Test Must Be Logged To Depth Feet Soil Characteristics 3-- 8m 9-- lOm ll-- 12-- 13= /&-- Overburden Gm Silty S~d GraYel Sw- ~Vell graded a~d Gravel nd Water f Yes , Gw= Wel~l~6re~_ed ~and Encountered? ~o~ I At What Depth? Dated Performed April 16~.1973 4 Subdivision Valhalla Percolation Test 4~ Below Proposed Seepage System - Reading Date Gross Time Net Time Percolation Rate Proposed Installation: Depth COM~ENTS: i M i - Seei',ag~ Pit X I Depth to H2O I t Drain Field Net Drop of Inlet___l~_, .............. Depth l;o Bottom of Pit Or TrenchNot knoym' Recommend about ].59 ~w square £eet ~er bedroom for a seepage pit. ' ~ 454?2 SIGNED SEND PARTS 1 AND :3 INTACT - Carbanlell PART :3 W LL BE RETURNED WITH REPLY. DETACH AND FILE FOR FOLLOW-UP DATE / POLY PAK (50 SET$~ 4P472 llNICIPALITY OF ANCHORAGE Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I. D. 015-211-11-000 Expiration Date- 10/3/2023 Legal description VALHALLA #1 BLK 4 LT 10 Site address 12035 WILDERNESS RD Anchoraqe AK 99516 Current property owner(s) YAHER JAMIE & GARRETT X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 3/22/2024 'This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory x Arsenic Advisory Other COSA Approvd June 2022 MUNICIPALITY OF ANCHORAGE o/ Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-211-11 Complete legal description Valhalla 41 Block 4 Lot 10 Location (site address) 12035 Wilderness Drive, Anchorage, AK Current property owner(s) Aaron Chavers & Emma Wolfe Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: © Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: © Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: © Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 24 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ® Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ S 5D Waiver Fee $ Date of Payment 2-1 z_o,00 z `� Date of Payment COSA # 0 S C- 2 y 10,3 5 Waiver # COSA Application—June 2022 COSA Checklist Legal Description: Valhalla #1 Block 4 Lot 10 Parcel ID: 015-211-11 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1973* Total depth 86* ft Cased to 86* ft 0 Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) 21 in. Date of flow test for COSA 2/14/24 Static water level at beginning of test 61 ft. Comments *Per 1999 HAA by Spurkland. B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping ❑ Required maintenance completed, if AWWTS Comments D. ABSORPTION FIELD DATA Which system tested (date installed) 11/13/86 0 ALL standpipes present per record drawing Total measured depth from grade 5.5 ft (max) Measured depth to pipe invert from grade 5 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑✓ Monitor tubes go to bottom of effective. If not, state depth into effective 0 Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 2/13/24 ate Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies COSA Checklist June 2022 Well production at time of test 4.9 qpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ✓❑ N ❑,/ Coliform bacteria is Negative Nitrate 1.15 mg/L [:1 Nitrate less than MRL (ND) Arsenic ug/L 2] Arsenic less than MRL (ND) Collected by Arcterra Consulting Date2/2124 STATION ❑ Require ate Age of lift station . Lift station material Comments: rice completed Adequacy test date 2/14/24 Results 0 Pass Fluid depth prior to test 0 in Water added 450 gal New fluid depth 0 in Elapsed time 10 min Final fluid depth 0 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) Effective depth used 0 in Effective depth remaining 6 in 6 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' 0 Yes if No Community Sewer Manhole/Cleanout > 100' ❑,/ Yes if No ft ] Yes if No ft Neighboring Tank > 100' ✓❑ Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100'✓❑ Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50'✓❑ Yes if No ft 0 Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' v Yes if No ft ❑✓ Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' J❑ Yes if No ft Tank to Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑✓ Yes if No *" ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10' ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' ❑Z Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Arcterra Consulting Phone (907)-696-6111 Engineer's Printed Name Kenneth Duffus Date _ 0_1!!7&/ 1,5-1? 91 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. �� ; The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The O !_ flow and absorption rates may change due to subsurface conditions that may not be observed from the��y*, surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic r systems are subject to these various and dynamic characteristics and are outside the control of the evaluators 'fig � of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will 0'`�1 function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen ff encroachments, deficiencies or discrepancies exist. f KENNETH M. FFUS C 7116 1�*Q FE55 ; 1* COSA Checklist -June 2022 Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: PID#: 015-211-11 COSA#:OSC241035 Permit#: Legal Description: Valhalla #1 Block 4 Lot 10 Engineer: Arcterra Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 0 feet. This waiver approval applies to the existing field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Date: Approve / I....:... ................................ r � / / Name of Reviewer .................................. **** VARIAN C E/WAIVER REVIEW **** March 15, 2024 RcE]l RA CONSULTING., INC 20441 Ptarmigan Blvd. Eagle River, AK 99577 Office (907) 696-6111, Fax (907) 868-3793 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Septic Field to Property Line Separation Waiver— VALHALLA #1 BLK 4 LOT 10 In the process of obtaining a COSA for the sale of this property we have verified the as - built separation distance between the septic field cleanout pipe and the west property line to be 8.65 feet. We are requesting a waiver be issued for the field to property line distance of 0 feet. The water samples on 2/2/24 show nitrates as 1.15mg/L and both arsenic and Coliform bacteria as Non -Detect. The septic system was installed 11/13/1986 and the inspection report noted the distance between property line to stand pipe as 10' and 8 feet to edge of bed, but no surveyor's as -built is noted in the MOA record file. This record information was used for HAA/COSA approvals in1999, 2014 and 2021. An as -built survey was completed by Robert Johns in 2014 but not all the standpipes were shown. An as -built survey was completed on 3/14/2024, which shows all record septic standpipes and a measured distance for the waiver between the southwest standpipe and the property line of 8.65 feet. We do not expect there to be any adverse effects to the existing well or neighboring septic system operations in the existing location. If you have any questions, please contact me at 696-6111/FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth . Du , P.E. Attachments: Schuller As -built February 29, 2024 Municipality of Anchorage ARC TERRA CONSULTING, INC 20441 Ptarmigan Blvd, Eagle River, AK 99577 Office (907) 696-6111, Fax (907) 868-3793 Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Conditional COSA Approval - Valhalla # 1 Blk 4 Lot 10 At MOA direction we are requesting a Conditional COSA to expedite the review and approval of this property for the pending closing scheduled for March 1, 2024. Due to the snow cover and conflicting record information on the location of the septic field you have determined that a site visit is necessary to resolve the need for a "field to property line waiver". The property has been tested and passed for both the well production and septic adequacy for the COSA. We do not expect there to be any adverse effects to the existing wells in the area or this septic system's operations in the existing location prior to construction in the spring. If you have any questions, please contact me at 696-6111 /FAX 868-3793 Respectfully submitted, ArcTerra Consulting, Inc. o11 Duffus, P.E. 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 MUHPCJPAUTY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT nnt�'�F; On-Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC241035 Subdivision: Valhalla #1 Block:4, Lot: 10 907-343-7904 Fax: 343-7997 The septic tank for this property is 24 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more, not including engineering, surveying or MOA permitting fees. 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 30 year old steel tank MAY look like. LOT 9 BLK 4 i I I, ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: VALHALLA SUBDIVISION ADD NO.1 LOT 10 BLOCK 4 PLAT 66-4 _ A� SUR t� SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a .� rr OT. �,t" ,_ A ,y oV physical survey of this property as shown on this drawing and that the `S v '' A�� ��� �� o'' rI� improvements situated hereon are within the property lines and no �e� enchroachments exist other than noted. Under no circumstance shoul 49TH any information on this drawing be used for construction of fences, k U \ structures, improvements, or for establishing boundary lines. va n C7 EXCLUSION NOTES: It is the owners responsibility to determine ' ' ..... ..• ' • . • "' ' t the existence of any easements, covenants, or restrictions which J01TN L. SCHULLER.- do not appear on the recorded subdivision plat. �� s LS -10408 WORK ORDER NUMBER: BArE �� E ua� `^P 5,� 1831 Talkeetna Street �> a `• E t a Anchorage, Alaska 99508 MAR 14, 2024 1"=30' schuller0nk.net A g 24__Q14 OftA15N BY: CHECKED 8Y GRD NUMBER B—acE: % � rOfessionok \" (907) 227-1455 office SLS SW2736 240114 ����®�� (907) 274--4992 fax I I LOT 11, I BLK 4 S89°59'19"E 168.55' i �C---x—x-x---� x SEPTIC 28.0' '.I 2 C��tYP O PIPE 'P ° ) ® W O Q ° � EXISTING c DECK (� OZ ° CANT N HOUSE Cd N — (1) in a w W ®t LOT 10 DECK 10.0' Qz 12.0' N �x 1 Zi o BLK 4 DECK o O O:f W N w 16.0' DECK (� O ..J OGRAVEL 22.0' ( � O D/W I Z I o m N x X----X,-----X_ x WELL x S89'59'19"E 1��' l 30' i I LOT 9 BLK 4 i I I, ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: VALHALLA SUBDIVISION ADD NO.1 LOT 10 BLOCK 4 PLAT 66-4 _ A� SUR t� SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a .� rr OT. �,t" ,_ A ,y oV physical survey of this property as shown on this drawing and that the `S v '' A�� ��� �� o'' rI� improvements situated hereon are within the property lines and no �e� enchroachments exist other than noted. Under no circumstance shoul 49TH any information on this drawing be used for construction of fences, k U \ structures, improvements, or for establishing boundary lines. va n C7 EXCLUSION NOTES: It is the owners responsibility to determine ' ' ..... ..• ' • . • "' ' t the existence of any easements, covenants, or restrictions which J01TN L. SCHULLER.- do not appear on the recorded subdivision plat. �� s LS -10408 WORK ORDER NUMBER: BArE �� E ua� `^P 5,� 1831 Talkeetna Street �> a `• E t a Anchorage, Alaska 99508 MAR 14, 2024 1"=30' schuller0nk.net A g 24__Q14 OftA15N BY: CHECKED 8Y GRD NUMBER B—acE: % � rOfessionok \" (907) 227-1455 office SLS SW2736 240114 ����®�� (907) 274--4992 fax Septic Pipe Offset from Property Line VALHALLA S/D ADDN NO. 1, LOT 10, BLOCK 4 I o� Q o O Ui � I< w � w V) w LJ z V) O O LLJIw O r-) Z -I w O � z 18.6 5' 30' OF A T _ PREPARED FOR: Af 4Tx - `l ` �, FIELD BOOKS COMPUTKENNETH �'`D �• S ED: �az3 CE -17• BOUNDARY: N .A. DRANK: r� a `'S STAKING: N/A CHECKED: AMUILT: SLS. DATE: FF . F�SSi DNS. FIM CMD: ACAD FILE: FILE JOB No.: ® SEPTIC PIPE (typ) S89'59'1 9"E 106.8' GRAVEL D/W S89°59'19"E 168. SCALE: 1" = 20' FhG F 8 G' lop Municipality of Anchorage ° On -Site Water and Wastewater Program Q 4 (907) 343-7904 x ° T CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-211-11 Expiration Date: __-1 C-5 . 1. GENERAL INFORMATION Complete legal description Valhalla #1 Block 4 Lot 1.0 Location (site address) 12035 Wilderness Drive,. Anchors a AK 99516 Current Property owner(s) Elisa Lear-Rayborn ____ Day phone Mailing address 12035 Wilderness Drive, Anchorage, AK 99516 Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual M Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class _Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Received by: %7 Date: COSA to be released to the engineer, unless asdse requested by the engineer. Distance: COSA Fee 5 5'O Waiver Fee $ Date of Payment 10-0A 1 Date of Payment Receipt Number 0206()& Receipt Number COSA # - O S CZ 1 1 ($ J _ 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. Name of Firm ARCTERRA CONSULTING INC. -,_ Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AIG 995,77___ Engineer's Printed Name KENNETH M. DUFFUS_ Date Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen OFA encroachments, deficiencies or discrepancies exist.110, i ��....�� 4 L\'I'I-lam 6. DSD SIGNATURE System #1 Approved for 3 bedrooms. System #2 Approved for bedrooms. Disapproved. Fr KI-NNET1 _ LTRIS of f Conditional approval for bedrooms, with the following stipulations: -.-_ _.� _____.__ ,��� - ( �i Q WATFE AND o WAST �"\J'IATER o^ ro P _IJ,I�FNT SERA, \NNI�1� J By: — _ ��/� _ _ Original Certificate Date: % a 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 Ira COSA blue sheet 10-10-12.doc * Per 1999 HAA by Spurkland, ** Per MOA file info dtd 3/18/99 ** ** Field verified 4 standpipes per asbuilt survey, no other pipes found under snow 11/24/21 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Septic Tank Advisory Certificate of On‐Site Systems Approval # OSC211689 Subdivision: Valhalla #1 Block:4, Lot: 10 The septic tank for this property is 21 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. 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 30 year old steel tank MAY look like. aft (EU f7FII5) Rd "Ra (ASSUNFA) PROP•JSM SUL-N C CCRN(P E)". (ASSUMM) ! ZONING aSMCT FRCNT BUiLDNO SETeAOt Sl� WIt04NIC. SETRACl5 WAR autaNC SEreAO LLJ co 0 0 0 J V1 -1 N89° 59' 00%AJ 108.55' O r --,,, - C . O. C J; �•'I---'�' i �^ 28. EXISTING I HOUSE 0.2' 12.0' N89 * 59' 00"kAf 168.' 5' NOTE: 0 0 0) LLI m 0 0 a Q 0 I WELL IS ENCROACHING INTO 10' UTIL ESMT I i U\" -)ER NO CIRCUMSTANCES SHCULO AN AS-EUILY EE .;SED FOR CONSTRUCTION OR FGR ESTABUSHINC BOUNDARY OR FENCE LINES. THE SURVE;'GI. TAKES RESPONSIBILITY FOR THE INIMAL TRANSACTICN ONLY FFD ASSJMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY. L:STED DISTANCES PREVAIL OVER SCALING. REPRODUCTION rd AY CAUSE ERRORS tN SCALE, LOT SURVEY SURVEY TYPE CvnaAnl c FOUNDATICH AS --.JILT FINAL STRUCTURE 4S -SUI!', PC0T PLAN . . . 4S -BUILT .. _ LOT SURVEY . _ . TCPOCRAPHY PLOT PLANS & LCT SURVEYS CRAINA�E � SET RESAR k." ASPHALT O F•)UNID RESZ� AR gen 8; We FENCE ': CONCRETE `UO ASSJMED E; -E','- ;( —n --)E METAL FENCE WOOD DEO N077 Il ly IML F£tiPUNSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY TI -.OSE I.'.IPR0VEtv1ENTS ABOVE GROUND AND VISIBLE WILL BE CCONSTRUCTiON. TO VERIFY PROPOSED BUILDING GRADE RZLATIVE SHOW`;. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GF -NDE AND UTILITY CONNECTIONS AND TO DE -•-ERMINE ETC., ARE 'SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE_ OF ANY EASEMENTS, COVENANTS OR RESTPiCT10NS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SURDI VISION ;-LAT. I ,AL.L_ DISTANCES ARE RECORD_ UNLESS OTHERWISE NOTED. SURVEY CERTrr*I('AT10N Prepared oyj /� PLOT FLAN�� OF ! r'r � � I \ o � e r �J �J I 1 n S . V I F 1 s .?c , th lotypr, 16dow;'—'h . --Yb t�r � .��\'��� Pmfpssic-id Lord Surveyors tM tot 4ro�n ote defiv,Z:' nxx_, of !h?t I 4y C- u na+r raMd z ptatlMeO a: or m, rot eomtr. .• ..i- '100 Brine Ori"-. cv wt= an mo on c a ti tnc Lett or n,; '� J:• r k+ox.dge ma ttiilk- a: alrenn_n. hof" Ce+n ANCHORAGE, ALASKA 9950+ moarw.d b— d CCT.^.' `- Si 1}QtI} �#•• SCcla. r, t Rec. Lot S.F. (Rec. PIaL Foe Na. FO(JUDATION AS -BC: = 1 •• • I. Robert E kYt�0. : �, b4'.b: —If thnt S --y y 1 ,� �• •"'" _.__.._....__.�___-___ .Dn —. Sur-!Y--- hovs per•I'omm m to -9:,1t e1 tea Iac&tlan m tete 6H cid tho: 1t ;le t.. tr.,tt .. ...,. ..,. t „ . ) �,[ r t�2f( 8!1 4 dine .Iwa and lM«r.:ul°ai thorn hre i r 1K oe We �+d na-rrmrir...: h n+d,f vnlpi' R`�HERT ,:OHh: ''• �.� ,jti GcLe Drcwr.: '� thorn ower.!x. 7y 0 8 (}��jj �( C3IQJI 1 03/03/14 •' I L a FINAL STRUCTURE u,�--3ULT�' Ar -fit t A b.rr Z Jar:ne. Y., n.rx; a,+try that It M, I A.-•9 Y ��s'`^ 'LCCOI 0tsen;: vn: Dtcttir, by RE r I Checked yk � K arid: 273 W.O. 14-51 ,..^.� t. a. .. !fie .. t 10 j'I " k 4 dl,n;vw f— ,.a . r. _ � r .t ,,. •ort:... 4 4 a' .p. :•� ..�:-a��-m= t� ��• .nw.: +�� ' ctessidnd. �-'� VALHALLA #1 Parcel I.D. # 1. MUNICIPALITY OF ANCHORAGE ~--~, DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 %, 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA # ~_ GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Day phone___ Lending agency Day phone Mailin. g address ' Agent ~l~-/~_ ~_~ ~.-~,%¢., ~'--~"~¢~-~.~Dayphone Address ' ¢;2.(¢¢ ~ ~,~t~.~L~ ¢-(- t4-/0 / Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ % TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev. 1/91) Front MOAe21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verifythat based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm -~b~¢~ -~,v,-t~_[,~,~ '~.)~- Phone ~-~l~ Address ~o 5 ~ ~ ~ ~ ~ Date EngineeF~ signature / DHHS SIGNATURE /~' Approved for 3 Disapproved. Conditional approval for bedrooms. bedrooms, with thee following stipulations: Additional comments Date z~ - / - ~'? The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesY to purchasers of homes and thei? lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage I'~l^p ~ ~o: ~ DEPARTMENT OF HEALTH & HUMAN SERVICES~ C [ I V J- L) Environmental Services Division 825L Street, Room 502, Anchorage, Alaska 99501, (907~'~4~-~4¥99 MUNICIPALITY OF ANC .~ ~(;~ Health Authority Approval ChecklJ~v~ONMEN~AL s~wc.~s u~v~slc~, Legal Description: Lo -k ~ F~ ~' ~ t,,,/,~,~/~,~ Parcel I.D.: &/~-- ~--//-- /( A. WELL DATA Well type Log present (Y/N) I"'-I Date completed Total depth ..~ Sanitary seal (Y/N) FROMV~ELL LOG Date of test If A, B, or C, attach ADEC letter. ADEC water system number \'"'/~/'~ 1779 Casing height (above ground) ~ ¢ ''/' Wires properly protected (Y/N) ~" AT INSPECTION ,, Static water level g.p.m. __ Other bacteria '~.) ~_. Well production g.p.m. ' WATER SAMPLE RESULTS: Coliform '~"- Date of sample: Nitrate Collected by: B, SEPTIC/HOLDING TANK DATA Date installed l~'~,~-~ Tanksize l~c,"-r_~ Number of Compartments ,~- Cleanouts(Y/N)_'~' Foundation cleanout (Y/N) t~ Depression (Y/N) ~'-/ High water alarm (Y/N) Date of Pumping ~/~/~'~:~ Pumper A + C. ABSORPTION FIELD DATA Date installed ~ ~ ~ .~ Length ,-~F~ /__Width Effective absorption area Date of adequacy test _. Soil rating (g.p.d./fF or fF/bdrm) ~-/~ Gravel thickness below pipe. Monitoring Tube present (Y/N) 7 Results (Pass/Fail) '~ Fluid depth in absorption field before test (in.); /~ ''~ Fluid depth ~'~ (ins) Minutes later: ,~,L/~.~ Peroxide treatment (past 12 months) (Y/N) ~ 72-026 (Rev. 3/96)* .~ -~z~.-~.~ ~ System type Total depth · Depression over field (Y/N) _ For ~ bedrooms Immediately after ~Ogal. water added (in.): Absorption rate = ~ ~ h' ~ g.p.d. If yes, give date D. LIFT STATION ~.,/~ Date installed Manhole/Access (Y/N) Size in gallons "Pump on" level at* "Pump off" level at* High water alarm level at*. *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SeptiC/t'iolding tank on lot Absorption field on lot On adjacent lots On adjacent lots Public sewer main r'-/,/~, Public sewer manhole/cleanout Sewer/septic service line ~ ~ c, Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation I ~ ' Water mai~sewice line ~ ~ ~ Property line ~ I c~ Surface water/drainage Absorption field ~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON.LOTTO: Property line ~/(.~ Surface water ~ / o Curtain drain Building foundation ~ ~ C, / Water main/service line Driveway, perking/vehicle storage area Wells on adjacent lots ~ /0''~> Signature Engineer's Name Date ~,/~.L./ HAA Fee $ ~C>E~, Date of Payment ~-\~;~ Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* CT&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID 990830001 Tobben Spurldand P.E. Lot 10 Bk 4 Valhala Lot 10 Bk 4 Valhala Drinking Water 0 Sample Remarks: Client PO# Printed Date/Time 03/11/99 15:33 Collected Date/Time 03/04/99 13:00 Received Date/Time 03/04/99 13:45 Technical Director: Stephen C. Ede Released By~~ / Resutts POL Units Method Attowabte Prep Anatysis Limits Date Date Init Total Coliform ~itrate-N 0 co[/lOOmL SM18 9222B 0.672 0.100 mg/L EPA 300.0 10 max 03/06/99 KAP 03/05/99 03/05/99 SCL RECEI'v l: MAR 18 1999 MUNICIPALITY OF ANCHO~AG[ ENVIRONMENTAl SERVICES DIVISIO~x MU.,C,PAL,TY OF A.C.ORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~.~_r'j~-,].O- I OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~:)//~ /~ GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant Name ~D~ ~ Telephone: Home Applicant Address (b) (c). Applicant is (check one): Lending Institution []; Owner/builder [~; Buyer []; Other [] '~,xplain); (d) Lending Institution Address Telephone (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [] Multi-Family [] Other Number of Bedrooms %, WATER SUPPLY Individual Well/~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the 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 72-025 {11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NHAWTHORNE - ENGINEERING Name of Firm ~ ,~,u c, ....... ! I-I:~1 ....... Telephone 7127 .............. ,,,,~ Address ~ch.~ AK 99502 344-47][). Date 2// I /~ WATER WELL NOTE: This Health Authority Approval inspection merely certifies that the subject water well produced 150 gallons per bedroom per day and that certified laboratory tests showed no presence of coliform bacteria in s sample of that water. No warantee or certification is expressed or implied concerning the long term adequacy or safety of the water supply. OR-SITE SEWAGE DISPOSAL SYSTEM NOTE: This Health Authority Approval inspection merely certifies that the subject on-site sewage disposal system accepted at least 1S0 gallons of water per bedroom per day as determined by methods approved by the Municipality of Anchorage Department of Health. and Human Services. Ho warantee or certification is expressed or implied concerning the long term adequacy of the on-site sewage disposal system. Construction data reported on buried system components is from MOA files and was not verified during this inspection. Approved fef'~.(?//~ bedrooms by ,,/~,. ~'~ Approved ~ .,- . Disapproved/~/ Conditional Terms of Conditional Approval CAUTION ~ The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representati~r~ given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 Lega, Descr p,on __A tO WELL DATA Well Classification Well Log Present (Y/N) Total Depth 6~ Static Water Level ¢'~ 8: $, If A, B, C, D.E.C. Approved (Y/N) ,A~ Date Completed (}~, ~ ~.., !.. v, Yield '~' Cased to -"% ~')/ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Depth of Grouting 2&) Pump Set At (~'/,~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) 91/ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole ./,3 Water Sample Collected by /!// Water Sample Test Results ~' Comments ~ ; On Adjoining Lots / /~(,) ~ ; On Adjoining Lots /~,¢ To Nearest Public Sewer To Nearest Sewer Service Line on Lot ~ (~ + ; Date B. SEPTIC/HOLDING TANK DATA Date Installed ~- ~7/'~ Standpipes (Y/N) _ Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ./V'/.~ Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line ,~ To Water Main/Service Line Course ..AJ//4T Size !C'~OO No. of Compartments C,/. Air-tight Caps (Y/N) _,Y Foundation Cleanout (Y/N) /'~ Date Last Pumped ~-/.Z. ;for .z.//./~ Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026 fRev 8/861 Fronl C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed I I .// / :2 Width of Field ..~ I Square Feet of Absorption Area //) '5-.,0 Depression over Field (Y/N) Results of Last Adequacy Test /LJ~co separation Distance from Absorption Field: Type of System Design Length of Field ,<~'-c"? To Water-Supply Well ~ I O<9 ~0 ~ To Building Foundation Lot /~.z~'- / TO Water Main/Service Line it.///~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Depth of Field '~ ~ - ~" Gravel Bed Thickness ~.a.~' / ~ Standpipes Present (Y/N) ~" Date of Last Adequacy Test ./L,/,~ ~zJ To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~ r'~ 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 ** I certify t hac,.t~ e/~c~or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ..c/~/~./.~ Date Company ~',.~ ,. ~-k~.r'v. ~. MOA No. Receipt No. '~O~ Date of Payment Amount: $ Page 2 of 2 72 026 IRev 8/86) Back MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENvIRoN~ENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 ·" "r Application,D{]te GENERAL INFOR relATION Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) ...... (b) Applicant Name ~ C.6~4~L.A~. Telephone: Home Business Applicam Address (c) Applicant is (check one): Lending Institution []; Owner/builder'~; Buyer []; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent . Address Telephone ,~ '~ ~ -~ I~t.¢'O (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Familyj~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well K Community [] Public Note: If corn munity 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 Environ mental Conse~ation attesting to the legality and status. Page 1 of 2 72-025(11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA A~ o! ti ~s ttf_,aitl~ '' ' t and es o~ the vahdabon date shown below, I verifv¥ Asced~fiedbymysealafflxedhereo . - .,, ~'~.~ ' , .,,¢btm~eo Author t A royal shows that the on-site water supp y and/or wastewater d~sposal syst¢ ' '" , ~-~- ,,~ mru~,- - ~ .. for the number of bedrooms and t e of structure indicated hereto. I fu~her verify that from the Mun c pa ty of Anchorage f es and from my nvestigabon and inspecbo~. the date of this inspection. '? ~ t 4' - ' Name of Firm' ~b'~ ¢ r~¢~ P~ Telephone ~'~ · Address ~ ~ ~ ~ / ~ Date Approved for ~//?/' ~, bedrooms by Approved ,.~,. Disapproved Terms of Conditional Approval Date CAUTION The Muncipality of Anchorage Department of Health and Environmental Protectio~ Approval certificates based solely upon the representations given in paragraph 5 abc,, ' engineer registered in the State of Alaska. The DHEP does this as a courtesy to purr.,- institutions in order to satisfy certain federal and state requirements. Employees of D~'' analyze data before a certificate is issued. The Municipality of Anchorage is not respo,' professional engineer's work. Page 2 of 2 MUNICIPA~.ITY OF ANCHORAG~ DBPT, OF HLAL~!i ~, ENVI~ONM~N1'AL II~O~CjlO~,j MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) -~,.i) 'J, i~ lg85 CHECKLIST- FEBRUARY 1984 Legal Description: ._Lro,~., WELL DATA Well Classification Well Log Present (Y/N) / Total Depth .~ ~:~"~ __ Cased to _ Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole ~,~E) Water Sample Collected by Water Sample Te.:.st Results Comments ~ ~.~ I If A. B, C. D.E,C. Approved (Y/N,) Date Completed ~'N~OT' ~4~ J~OL'~J~ ~"/Yield Depth of Grouting 1~4D j~g::~-- Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) N ; On Adjoining Lots j~ ¢0 ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot /ezA),,,?''_ B. SEPTIC/HOLDING TANK DATA Date Installed '-~/7/7,~'-'~ Standpipes (Y/N) ~ Air-tight Caps (Y/N) 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 ~, Size IO"O"~ No. of Compartments ~ Foundation Cleanout (Y/N) __ Date Last Pumped ;for ~"~/'f-'~ Temporary Holding Tank Permit (Y/N) Course To Building Foundation / ~ To Disposal Field '~ JO To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026(1 ~/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~/~/7~ Width of Field., ~)Z4 ~ t,,~,¢,'l~ Square Feet of Absorption Area Depression over Field (Y/N) Results of'Last 'Adequacy Test Separation Distance frdrn Absorption Field: To Water-Supply Well To Building Foundation Lot /*~..O To Water Main/Service Line ~ / O To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comment~ ';i~,'~. Standpipes Present (Y/N) Date of Last Adequacy Te~t Type of System Design ,~L~ Length of Field 0 ¢~, ~ ¢.~ Depth of Field ~) Gravel Bed Thickness /~ ! To property Line f.~/,4,~,:,-~4,,,/ To Existing or Abandoned System on ; On Adjoining Lots ~ '~-~ TO Cutbank (if present) ~'0 ~¢.~ NONE. ~,~o D. LIFT STATION /~ ON E Date Installed Size in Gallo~__ '~P~i;~/~W/WWater AlarmOd'' Level ~:evel at Tested for Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, ve.r,i;fied, or conformed to a. II MOA and HAA guidelines in effect on the date of this inspection: Signed '~"~ - Date Company **~ /! MOANo. Receipt No. '~ Date of Payment Amount: $ Engineer's Seal Page 2 of 2 72-026 (11/84) ~,--~03 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 CONSULTING ENGINEER RESIDENTIAL WELL INSPECTION LEGAL: LOT 10, BLOCK 4, VALHALLA LOCATION: 12135 WILDERNESS DRIVE OWNER: JOE CHANGE TYPE OF WELL: SINGLE FAMILY WELL LOG AVAILABLE: NO INSTALLATION REQUIREMENTS MET.' YES WELL YIELD FROM WELL LOG: UNKNOWN PUMP YIELD: DATE OF INSPECTION: MORE. THAN 6 ~ALLD~L~_~MINUTE SEPTEMBER 11, 1985 TEST PROCEDURE: TEST FOR COLIFORMS: TEST RESULT: 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. THE STATIC LEVEL WAS FOUND TO BE 67 FEET. DRAWDOWN AFTER THREE HOURS AT 6 GPM WAS 84 FEET. WATER WAS TESTED FOR COLIFORM BACTERIA ON SEPTEMBER 4, 1985. TEST WAS NEGATIVE. THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. 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. CONSULTING ENGINEER TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOT 10, BLOCK 4, VALHALL LOCATION: 12135 WILDERNESS DRIVE OWNER: JOE CHANGE RESIDENCE: SINGLE FAMLIY, THREE BEDROOMS WATER SYSTEM: ON SITE WELL SEPTIC SYSTEM: DATE OF PUMPING: FROM MUNICIPAL RECORDS: TANK: STACK STEEL, STEEL, TWO COMP. 1C00 GAL. ABSORPTION SYSTEM: CONCRETE CRIB AND TRENCH ABSORPTION AREA: MORE THAN 468 SQ. FT. SOIL RATING: 159 INSTALLATION DATE: CRIB AND TANK IN JULY 1973, TRENCH IN 1976 PER LETTER IN FILE. SEPTEMBER 13, 1985 DATE OF TEST: SEPTEMBER 11 AND 12, 1985 SYSTEM HAS NOT BEEN IN USE FOR SEVERAL MONTHS. WHEN INSPECTED ON SEPTEMBER 11 CRIB WAS FOUND DRY. 1000 GALLONS OF WATER WAS ADDED TO THE CRIB WITH THE WATER DEPTH MONITORED.BY THE MORNING OF SEPTEMBER 12, 900 GALLONS HAD BEEN ABSORBED. AGAIN 1000 GALLONS WERE ADDED. THE NEXT DAY THESE 1000 GALLONS HAD ALSO BEEN ABSORBED. ~%~E%T,,.R~$~': THIS SYSTEM MEETS THE ABSORPTION REOUI~ENTS ~.~ '~'2':-~? ,.QT THE MUNICIPALITY Qw 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. ~ DATE RECEIVED ' INSPECTION APPOINTMENTS ,NSPECTOR MUNICIPALITY OF ANCHORAGE DEPT. OF H~ALTit & ~ ENVIRONMENTAL SANITATION DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATEB AND SEWED FACILITIES 5. LEGAL DESCRIPTION TREET LOCATION I~o~' LJ/.~.C.,~'~ ~. /)/~/[,//o~q~ ,q~ ~9~o~ TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four J~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other 7, WATER SUPPLY .,~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8, SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** '/-,~ YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTI LITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE [].~31N G LE EAMILY [] MULTIPL.E FAMILY 2. WATER SUPPLY E~INDIVIDUAL [] COMMUNITY [] PUBLIC LITI LITY Connection Verified DiAGE DISPOSAL SYSTEM VIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [~Holdin§ Tank Size: z/~ > O If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AR EA ~, ~;~,g! 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line NUMBEROFBEDROOMS ~.~ [] ONE E~" THREE [] FIVE [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING Septic/Holding//(~?Tank" Absorpti, on//~[~ ~-)Area~:~' Sewer Line E~] OTHER Nearest Lot-~i~ 5. COMMENTS [~"/APP ROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE 72-010 (Rev, 6/79) ALASKA enviRonmenTAL COrlTROL J~ngin¢¢rin§ $ ~nuironm~nlaJ $1uc~ies Sl ltUlCe$, lilt. /,AUNICIPALITY OF ANC' DEPT. OF HEALTh 9/15/81 RECEIVEb BARBARA DAVIS SRA BOX 1588 T ANCHORAGE AK 99507 SELLER - BARBARA DAVIS SUBDIVISION-VALHALLA SUBDIVISION BLOCK-4 LOT-10 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 468 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 150 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 107 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 3 BEDROOMS. THE SEPTIC TANK WAS PUMPED ON 9/4/81 SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 3 BEDROOM HOUSE. 1000 IS ADEQUATE FOR 1220 LJUest 25th J~uenu¢ · J~nchore§e, J~laska 99503 · (907) 276-1361 ALASKA erlUIROrlmI IqTAL COIqTROL ~nclin~erin~, ~, ~nui~'onmental Sludi~s IHI,'.D~:?T. (.F i".:, i: ~. I ECEIV D September 28, 1981 Municipality of Anchorage 825 L. Street Anchorage, Ak. 99501 Attn: Les Bucholz Dear Les: On September 25, 1981 I retested the on-site sewer system for Barbara Davis; Lot 10, blk 4 Valhalla Subdivision. The system had been upgraded by Chuck's Backhoe and Bell's Plumbing around 1976. The plumber had Chuck install a trench which was about 12 feet deep with 6 ft of rock. It appears to run from the existing crib to near the NW corner of the lot at a level which is about 2 inches higher than the level of the septic tank outlet. I introduced 176 gallons of water until the level in the tank rose. Then the system took and additional 278 gallons before the level rose anymore. At that time I ran my adequacy test and determined that the system would accept at least 450 gallons per day. Sincer~ PE 1220 U3est 25th Auenue · Anchoraqe, Alaska 99503 · {907) 276-1361