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Home My WebLink AboutUS SURVEY 3042 LT 3 T10N R2E SEC 19Onsite File US SURVEY 3042 Lot 3 PID# 075-132-05 T10N R2E SEC 19 As of March 2025, all wells on this lot are regulated by the MOA. See ADEC letter dated 23 September 2020. THE STATE fALASKA GOVERNOR MICF-LAEL J. DUNLEAVY September 23, 2020 Department of Environmental Conservation DIVISION OF ENVIRONMENTAL HEALTH Drinking Water Program 555 Cordova Street Anchorage, Alaska 99501 Main: 907.269.3076 Fax: 907.269.7650 thomas.brannan;s alaska.gov File: US Survey Lot 3 T1ON R2E Sec 19 — Powder Run Moises Gutierrez NO ADDRESS — Vacant Land Development MGJ Building Group Inc. Class: Proposed - Private 12870 Old Seward Hwy. St. 1008 Source: Proposed - Three Onsite Wells Anchorage, AK 99515 molses@mg)buildinggroup.com Re: US Survey Lot 3 T10N R2E Sec 19 — Powder Run Private Water System Classification Determination Rescinds and Supersedes Classification letter Dated September 11, 2020 Dear Moises Gutierrez: On August 12, 2020, the Drinking Water Program (DWP) received a submittal requesting classification of a proposed water system to serve the subject property development. Additional information concerning expected population to be served by the water system was received August 313, 2020. The subject proposed water system was classified as Public by the DWP, however this letter rescinds and supersedes the September 11, 2020 letter. Based on review of the submitted data and other DWP policy guidance, it has been determined that the subject proposed water system would be classified as a PRIVATE WATER SYSTEM. SYSTEM CLASSIFICATION: PRIVATE WATER SYSTEM SERVICE AREA & POPULATION INFORMATION Proposed Water System Three individual wells, one serves a duplex, one serves two duplexes, and one serves a tri-plex; all on one parcel NUMBER OF SERVICE CONNECTIONS 4 proposed (total) NUMBER OF DAYS PER YEAR OF OPERATION Year-round Residents RESIDENTS (PRIMARY PLACE OF ABODE) 54 Total - (12, 24, & 18 — per well) NON -TRANSIENT 0 TRANSIENT 0 The subject proposed water system will serve the new land development of Powder Run. Powder Run is to be situated on US Survey Lot 3 T10N R2E Sec 19. The 1.5 acre parcel is located at the Southeast corner of Sproat and Gunnysack Mine roads in Girdwood, Alaska and is fronted by sanitary sewer conveyance, storm water conveyance, major roads, and other infrastructure. The parcel will be developed to contain a total of nine 3-bedroom residential units spread across four separate structures (strip footings with crawl spaces). Of the four structures, three are duplexes and one is a triplex. Potable water for the development will be provided by three separate proposed on - site wells, each with a separate distribution system that are not connected to the other wells Of the three wells, one will serve the tri-plex structure, one serves two duplexes, and one serves one duplex. Moises Gutierrez 2 September 23, 2020 Under 40 CFR 141 and 18 AAC 80, based on the configuration of and population served by the subject proposed water system, it is classified as a Private Water System. Private Water System Recommendations The State's DWP does not regulate Non -Public Water Systems. More information concerning Non- public Water Systems can be found at: htW://dec.alaska.gov/eh/dw/dwp/private-wells/. Records pertaining to this system will be filled for future reference and shared with other agencies or jurisdictions which may regulate your system. While not required to be submitted to the DWP, it is recommended that each well of your potable water system be routinely sampled for bacteriological contaminants (specifically total coliform quarterly), nitrates annually, arsenic at least once (or as needed), and other chemical contaminants such as Volatile Organic Compounds (VOCs) and etc. at least once (or as needed). The recommendations made herein are not an exhaustive list; it is the responsibility of the water system owner to ensure the safety of the water they serve. Limitations & Appeal Process This determination is not approval of omissions or oversights by this office or non-compliance with any regulation. This does not imply the granting of additional authorizations, nor obligate any federal, state, or local regulatory body to grant future authorizations to this project or any future projects with similar conditions. This determination does not guarantee correctness of functional design or waiver the owner's responsibility for continued compliance with state, federal, and local regulations. The applicant, owner or operator, or other person adversely affected by this decision may request an informal review of this decision in accordance with 18 AAC 15.185, or may request an adjudicatory hearing in accordance with 18 AAC 15.195-15.340. Requests may be sent by mail, email, or facsimile. Informal review requests must be received by the Division Director within 20 days of this decision. Adjudicatory hearing requests must be received by the Commissioner within 30 days of this decision or the decision of the informal review issued by the Division Director; otherwise, the right to appeal is waived. For more information, visit https://dec.alaska.gov/commish/review- guidance If you have any questions regarding this determination, please do not hesitate to contact me. Sincerely, C'e; Z Cindy Christian Program Manager DEC Drinking Water Program Cc: Jeff Warner, DEC-EH-DW, jef£warner@alaska.gov David Gamess, Garness Engineering, David(&garnessengineering.com Powder Run —Private Water System - FINAL (003).docx Certified Drilling log P DOC CO dba BILL & COLE 4-►ULLIVAN WATER WELLS P.O. Box 670269, Chugiak, AK 99567 1688-2759 OWNER OF LAND: MGJ Building Group ADDRESS: LEGAL DESCRIPTION US Survey 3042 L3 T10N R2E Sec 19 DATE: 2-15-22 PERMIT DATE OF ISSUE: NUMBER: TAX IDENTIFICATION NUMBER Is well located at approved permit location: ❑Yes ❑No Method of Drilling: ®air rotary ❑cable tool Depth of Well: 105' Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 105 feet Liner type Static Water Level: 73 feet Recovery Rate 25 F71gpm ❑ gph Method of Testing Air Well Intake Opening Type: ❑ open end ❑open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite Volume: 200 Ibs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: ®yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Well #2- Triplex Bore Hole Data Depth From To 0 2 2 4 4 7 7 22 22 37 37 69 69 84 84 88 88 105 Casing Stickup Peat & Mulch Fill Hardpan & Cobbles Tight Silty Sand & Gravel Loose Sand & Gravel w/ Cobbles Silty Sand & Gravel Sand & Gravel 10 GPM Sand & Gravel 25 GPM Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. Well Drilling Permit Number: SW Parcel Identification Number: 0 Mn co dba BILL ac COLE ULLIVAN WATER WELLS P.O. Box 670269, Chugiak, AK 99567 688 2759 www.suilivanwaterwells.com Pump Installation Log OSP221030 Date of Issue 2-14-22 075-132-05 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 4 SGS Re£# 1230196001 Client Name Sullivan Water Wells Project Name/# 115-152 Sproat Client Sample ID 115 Sproat Hosebib Matrix Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 01/24/2023 10:03 01/16/2023 12:00 01/16/2023 13:31 Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 B (<10) 01/17/23 01/20/23 HGS Waters Department Total Nitrate/Nitrite-N 0.379 0.200 mg/L SM21450ONO3-F C (<10) 01/20/23 EBH Microbiology Laboratory E. Coli Negative I 100mL SM21 9223B A 01/16/23 MA Total Coliform Negative 1 100mL SM21 9223B A 01/16/23 M.A Certified Drilling log P DOC CO dba BILL & COLE 4-o-ALLIVAN WATER WELLS P.O. Box 670269, Chugiak, AK 99567 688-2759 OWNER OF LAND: MGJ Building Group ADDRESS: LEGAL DESCRIPTION US Survey 3042 L3 T10N R1E Sec 19 DATE: 2-16-22 Bore Hole Data Depth From To PERMIT DATE OF ISSUE: NUMBER: TAX IDENTIFICATION NUMBER Is well located at approved permit location: ❑Yes ❑No Method of Drilling: ®air rotary ❑cable tool Depth of Well: 125' Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 125 feet Liner type Static Water Level: 70 feet Recovery Rate 30 LLjgpm gph Method of Testing Air Well Intake Opening Type: ® open end ❑open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite Volume: 250lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: ®yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Well #3 —two buildings 0 2 2 4 4 39 39 90 90 109 109 115 115 125 Casing Stickup Overburden Silty Sand & Gravel Sand & Gravel Tight Silty Sand & Gravel 10 GPM Sand & Gravel 15 GPM Sand & Gravel 30 GPM Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. P DOC CO dbe BILL 8& COLE ,0-►ULLIVAN WATER WELLS .� P.O. Box 670269, Chugsak, AK 99567 688-2759 www.suilivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP221030 Date of Issue 2-14-22 Parcel Identification Number: 075-132-05 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. ilk � �x�iNll SGS Ref.# 1230196003 Client Name Sullivan Water Wells Project Name/# 115-152 Sproat Client Sample ID 152 Sproat Wellhead Matrix Drinking Water Printed Date/Time 01/24/2023 10:03 Collected Date/Time 01/16/2023 12:30 Received Date/Time 01/16/2023 13:31 Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 B (<10) 01/17/23 01/20/23 HGS Waters Department Total Nitrate/Nitrite-N ND 0.200 mg/L SM21450ONO3-F C (<10) 01/20/23 EBH Microbiology Laboratory E. Coli Negative 1 100mL SM21 9223B A 01/16/23 M.A Total Coliform Negative 1 100mL SM21 9223B A 01/16/23 M.A w' L L L--- �1- tQ"O (mot U i L -3 l /\.• C-15' LIZ Sur �w ACxA� _ kp 1� Ar O Unit Unit 2 Unit 3 ? \ 2✓ Unit 4 Proposed Asphalt Driveway Unit 5 O sg Unit 9 Unit / s _ I unit s / o_ Lo USS Lot 2A N683333„ Unit 7 / 0 tv 33020 LEGEND 6 ® Sewer Manhole Comm. Pedestal \� L (_ �- 3 �wO J1 L.-O i /v C, S r Utility Pole Lot 2C Well Overhead Utilities l Proposed Edge of Asphalt NOTES T -All dimensions shoran are grid bearings and ground distances. Z 3 s �F I z K0 2 / -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. -It is the owners responsibility to determine the e�dstence of any easements, covenants, or restrictions which do not appear on the recorded US Survey subdivision plat. M =I Sewer Manh6le Comm. Pedestal utility Pole Wa Overhead Utilities Proposed Edge of Asphalt 'Star surve 1, ying 0 20 40 US SURI-VEY FEFr 2nd F1r. Deck 2931 8.0# Toumhome Footprint (Scale: 1 20) -All dimensions sho-*,vn are grid bearings and ground distances. -49th Star has conducted a physical survey of the property and aU details shown on this Asbuilt Sim7ey are correct. I -It is the ourners responsibility to determme the existence of any easements, covenants, or restrictions which do not appear on the recorded US Survey subdivision plat. I W.O. 1:903 3 DATE 1/26/23 1 SCAIR 1"-40' 00, PLAN 0 20 40 80 Scale in Feet 1;r4 9 7 Sewer Line As—Built PROFILE Station 1+.00 STA 2+21 z Table CLEANOUT LOCATION STA 1+25.3 0 Easting Description CIPNOUT LOCATION So *0 00 0 0 as STA 1+05.4 1788291.65 SEWER CLEANOUT *I /yl�+ ) CLEANOUT LOCA11C N 1788260.28 mmm mom 10 GRADE BREAK STA 2+18.37 0 1788231.70 MMlmmm STA 1+25.3 0 • 1788213.72 z ��Mlmm 2539009-46 1788128.15 0 DESIGN SEWER LINE LOCATION FINISHED GE RAD M=lmmm mmO=I SURVEYED 10/10/22 ........................................................... • • --- - -------- 9,5. 09. ------------- ---------- ------ ... ... . .... jl 0 ------------ ------- 0 0 54% AS—BUILT SEWER LINE LOCATION 51 .53, 08.68% 0i 06 GRADE BREAK STA = 1+23.32 - ---- 66.3 _ ------ 0 5 27% 0 5.2 7% ELEV = 76.330 6 ---------- ---------- ------- -- ---------- ----- -- --- - - ------------ -- ----- - -- --------- 5.59' 9, 0 0 4.48X --- -------- - ------ ------- GRADE BREAK STA = 0+00.11 ELEV = 68.129 Nflummommmme] HORIZONTAL SCALE 0 15 30 60 Scale in Feet 1+*00 vER,nCAL SCALE 0-�0111 0 7.5 15 30 Scale in Feet NOTES #1 BASIS OF ELEVA11ON IS TBM 605, A FOUND SPIKE IN SPRUCE TREE N: 2539111.164 E: 1788361.441 EL.=74.86' . #2 COORDINATES ARE NAD83 ALASKA STATE PLANE ZONE 4. #2 DATE OF SURVEY 6/11/22, 6/2/22, 6/6/22 & 10/10/22. LEGEND AS -BUILT SEWER LINE SEWER CLEANOUT DESIGNED SEWER LINE EXISTING SEWER LINE 100' WELL RADIUS Point Table Stationing Northing Easting Description STA 0+18.3 2538891.16 1788291.65 SEWER CLEANOUT STA 0+84.3 2538948.19 1788260.28 mmm mom STA 1+05.4 mm 1788231.70 MMlmmm STA 1+25.3 2538969.16 1788213.72 MINIM ��Mlmm 2539009-46 1788128.15 MWINNIM —0 M=lmmm mmO=I mmm LEGEND AS -BUILT SEWER LINE SEWER CLEANOUT DESIGNED SEWER LINE EXISTING SEWER LINE 100' WELL RADIUS OF 'fit � fit H jo, *A— Pie M. 5 r N LS- 12 too 1/19/2023 low WW Ss* Iot4�� 144tkW***1*1 WN IC N ra X A RUM NMI S. SIR OEM POWDER RIDGE DEVELOPMENT US SURVEY 3042; LOT 3 T10N R2E SEC. 19 CW1 P. STRAGIER SEWER LINE AS—BUILT 17777my FS 22-017 Point Table Stationing Northing Easting Description STA 0+18.3 2538891.16 1788291.65 SEWER CLEANOUT STA 0+84.3 2538948.19 1788260.28 SEWER CLEANOUT STA 1+05.4 2538960.59 1788231.70 SEWER CLEANOUT STA 1+25.3 2538969.16 1788213.72 SEWER CLEANOUT STA 2+21 2539009-46 1788128.15 SEWER CLEANOUT OF 'fit � fit H jo, *A— Pie M. 5 r N LS- 12 too 1/19/2023 low WW Ss* Iot4�� 144tkW***1*1 WN IC N ra X A RUM NMI S. SIR OEM POWDER RIDGE DEVELOPMENT US SURVEY 3042; LOT 3 T10N R2E SEC. 19 CW1 P. STRAGIER SEWER LINE AS—BUILT 17777my FS 22-017 Certified Drilling Log Q BILL & DOC CO dba ►ULLIVAEN WATER WELLS W;PP.O. Box 670269, Chugiak, AK 99567 688-2759 OWNER OF LAND: MGJ Building Group ADDRESS: LEGAL DESCRIPTION US SURVEY 3042 L3 T10N R2E Sec19 DATE: 2-15-22 Bore Hole Data Depth From To PERMIT OSP221030 DATE OF ISSUE: 2-14-22 NUMBER: TAX IDENTIFICATION 075-132-05 NUMBER Is well located at approved permit location: Yes AfNo Method of Drilling: air rotary ❑cable tool Depth of Well: 105' Casing Type: Steel Wall thickness 250 inches Diameter: 6 inches, depth 105 feet Liner type 0 2 2 5 5 24 24 38 38 71 71 86 86 91 Static Water Level: 75 feet Recovery Rate 20 j—gpm —❑— gph Method of Testing Air Well Intake Opening Type: ® open end ❑open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite Volume: 100lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: ®yes no Method of Disinfection: Chlorine 50 PPM Comments: Welt #1- Duplex 91 105 zo z3 Casing Stickup Overburden Hardpan & Cobbles Silty Sand & Gravel Loose Sand & Gravel w/ Cobbles Silty Sand & Gravel Sand & Gravel Water 8 GPM Sand & Gravel Water 20 GPM Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. DOC CO dba 00BILL & COLE WULLIVAN WATER WELLS 0;—.. Bm 670269 Chu iak, AK 99567 688-2759 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP221030 Date of Issue 2-14-22 Parcel Identification Number: 075-132-05 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. i—� MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 i ' 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http:/Iwwv.muni.org/onsite S fHORA6E On -Site Water System Permit Permit Number: OSP221030 Effective Date: Work Type: Well Initial Tax Code Number: Site Legal Address: Site Mailing Address: Owner: US SURVEY 3042 LT 3 T10N R2E SEC 19 G:5012 Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Expiration Date: 2/14/2022 2/14/2023 Lot Size in Sq Ft: 65340 Total Bedrooms: 6 Q Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 'lw� L L R_ 1 DU PC Ex Issued BY`_--�1/Vd2' _ Date: f r �— Date: 2 2 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section �='` Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D.rd- 075-132-05 Property owner(s) JMG BUILDING GROUP Day phone 907-306-9145 Mailing address NHN GUNNYSACK MINE ROAD *GIRDWOOD, AK Site address Legal description (Sub'd., Block & Lot) US SURVEY 3042; LOT 3 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 6 APPLICATION IS FOR: (® all that apply) Upgrade .. Absorption Field Renewal Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage ❑ APPLICATION IS AN: Initial 0 Upgrade .. ❑ Renewal ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) Multiple Dwellings (SF and/or D) Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. of property owner or auth ized agent) Permit/Rush Fees: $2 2- S Waiver Fees: Date of Payment: v2 z.Z Date of Payment: Receipt Number: 0 0 0 I G Receipt Number: Permit No. (bpa 2 /03D Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterlForms\Client FormsTermit Application.doc 01 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221030, Deb Wockenfuss, 02/14/22 MUNICIPALITY OF ANCHORAGE Development Services Department - .'� Phone: 907-343-7904 On -Site Water & Wastewater Section-' Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 075-132-05-009 Expiration Date: 8/7/2025 Leqal description US SURVEY 3042 LT 3 T10N R2E SEC 19 POWDER RUN Site address 116 POWDER RUN LN Girdwood AK 99587 Current property owner(s) SIMMONS LESLIE D &SLAUGHTER MARK WILLIAM 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: 11/12/2024 his 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 Arsenic Advisory Other COSA ApprovaLkne 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water J?_ IN Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application Y PP PP 1. GENERAL INFORMATION Parcel I.D. 075-132-05 Complete legal description US Survey 3042 Lot 3 T1 ON R2E Section 19 Powder Run Location (site address) 122 and 116 Powder Run Lane, Girdwood, AK 99587 Current property owner(s) Mark Slaughter & Leslie Simmons 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 Gr.71Pliiiiiiiiiiiii��1q Age N/A - See advisory if steel older than 20 years 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 $ z Date of Payment l Z Z COSA # 6 Z y y C-� Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 US Survey 3042 Lot 3 T10N R2E Section 19 Powder Run 075-132-05 N/A 02/15/22 105 N/A 105 0.48 >18 N/A Forge Engineering N/A 8/7/24 Well serves two properties and cannot be isolated for well testing. > Property is served by AWWU Benjamin Schiller, P.E.11/8/24 N/A N/A Property is served by AWWU (907) 522-7773 coce) �C? O O CD CD LU o L V a_ 0 2 U Z a 7_// J � a - n C U L L^' - Q W Z U� U .L 06 co L C E� o_ O > U) a) c 00 LJ LO N O N co ai cu D C O .Q X W co CD0 LO O N M ti 0 a) U d Z ry W 0 U W W N Z LLCD 1� J N C) M �W L.L U) c O ,-r— U) U) () an a) J r - co LO 0) CD Q O O ,L. V J D Of W a_ N N U m cu a� O C/) ) L (ti L 06 ^U) W a) 0 a) 0- 0 n C: U r�t'7 0 70 > O Q cu a) L m Ln E a) (n a) N c 0 a) m A ON i M V O =O O O CL ^, Q /W�� CL o c E F— O � U � d � O p C � N � C CL — •� E ui V) +� = Oi 3 0 a O � m i C > O d CL CL Q V E c 0 �+ = co cQ N a . O o O> O a) +O+ C v N O �j E o w N a) t V NQ. k N Q � L X O V) .Ln Y> U LL 70 OQ U Za) p Q Z ~ LO Y W O U Q F: O 2 U Q H Q a a 0 U 0 cv .Q Q ca O Q- cn (\n CO W C 0 O N W W, W O O Z U') 09 Q M -r-- 0 O LO LL Z O QJ Q W = Z v LU 0 n N O _U L c O N > a > m d (Y) U) o C O - N j d 0 I� >, N O 0) O •U •c :3 3 �= = E E o U U C C) U co D CL N •� ❑ n (n a) U c ca � � a a) _ 13 ❑ U O cru > + M n � d �N a) U O❑ c co /}� \V co W m — N a) cm o C/)J L I'1 ❑ N A 1 CMI > L > (� Na, /V�J «/ ) O N fn N El J� a co L E] E:]-+ 0 a. w Q yO L wwL r W Q F• Q o O- y W F- LL O N Mn LL O O Cl) W .0)) W z a ❑ a U O ~ L F- N M d• a) LL Lm C, c () M 0 m *k a) c m >1 co IL 0 a) 0 R L N ? d N U) C U d O cB •U U U _ CL ❑ E a) U 13 O E E °' U c r ~M L O m a) N Mn D O .0)) ❑ A0) Q. i.f. L O = Q- O o a) a) L � U) O ❑ EQ a) r voi -a ->O a) j y- O m a) a) >, CD a Q N V ) V) L L) .� � O LV C/) a) w m Z L a) >+ a) L :tl' a _ Q > a) Md ' mn w �> m a) LL Lm C, c () M 0 m *k a) c m >1 co IL 0 a) 0 US Survey 3042 L3 T10 R23 SEC 19 075-132-05-008 N/A 02/15/22 105 N/A 105 0.48 N/A Forge Engineering N/A 8/7/24 N/A N/A N/A > Benjamin Schiller, P.E.8/21/24 N/A N/A Property is served by AWWU. (907) 522-7773 HUHUPAUTYOFAHCHORQGE Development Services Department 4. p p � - T Phone: 907-343-7904 On -Site Water & Wastewater Section Fax- 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 075-132-05 Legal description US SURVEY 3042 LT 3 Site address 122 and 116 Powder Run Lane Expiration Date: 7/5/23 Current property owner(s) MGJ BUILDING GROUP LLC X The On-site system(s) is/are approved for 3/3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: BY lav Original Certificate Date: 4/5/23 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 Arsenic Advisory Other COSA Approval—June 2022 MUMCIPAUTY OF ANCHORAGE »o zA Development Services Department P P 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. 075-132-05 Complete legal description US SURVEY 3042 LOT 3 Location (site address) 122 AND 116 SPROAT ROAD Current property owner(s) MGJ BUILDING GROUP Day phone 907-306-7079 2. ON-SITE SYSTEMS SIZED FOR 3/3 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well 0 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 0 Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS Deep Trench ❑® Wide Trench ❑ Seepage Pit Waive 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 $-?, —0 Date of PaymentYZ31Z I COSA# OSC 2'310130 Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist Legal Description: US SURVEY 3042 LOT 3 T10N R2E SECTION 19 POWDER RUN Parcel ID: 075-132-05 If more than I well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA X Well log is filed with Onsite (or attached) Date drilled 2/15/2022 Total depth L05 ft Cased to 105 ft 9 Sanitary seal is functioning correctly ny Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 2/15/2022 Static water level at beginning of test 15 ft. Comments B. TANK DATA Measured operating fluid level in Date of pumping M Requires Well production at time of test 20 gpm Water storage tank volume N/A gallons Well disinfected for coliform test?Yes El No ML Coliform bacteria is Negative Nitrate mg/L nN Nitrate less than MRL (ND) Arsenic ug/L 9 Arsenic less than MRL (ND) Collected by SULLIVAN WATER WELLS Date 1/16/2023 ISERVED BY AWWU SEWERI C. LIFT STATION -15 �k ❑ Required maintenanc r — Age of lift statin years completed, if AWWTS Lift stat' aterial D. ABSORPTION FIELD DATA Which system tested (date installed) Fj ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) El N/A — pressurized field. El Per record drawings, field is insulated. F1 Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if Presoaked required (Required if house vacant or not used for more d if vacant not used than 30 days prior to da test) Gallons introdu I s -gallons date A j Any rejuve n treatment (past 12 months) I s, enter date Adequacy test date -.00 Results n Pass esu' s Pass Fluid depth prior to t in prior Water added _ gal New i depth _ in ern apsed time min Final fluid depth _ in Absorption rate _ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in A Comments/Deficiencies: SEWER LINE RECORD DRAWINGS HAVE NOT BEEN APPROVED AND/OR SUBMITTED TO AWWU ?4 COSA ChecklistJune2022 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' Community Sewer Manhole/Cleanout > 100' ❑Yes if No NIA ft FC Yes if No ft Neighboring Tank > 100' ❑m Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No * ft Absorption Field on Lot > 100' ❑ Yes if No N/A ft Holding Tank > 100' W Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft Rm Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' DYes if No ft 0 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 Building Foundations > 10' Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' ,,,,• Line > 10' ❑ Yes if No ft ❑ Yes if No ft ❑Yes i ft Yes if No ft ❑ Yes if No ft Surface Water > Adjacent Lots: Private Wells > 100' Community Wells > 200' Yes if No ft ❑ Yes if No ft ❑ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS "SEE ATTACHED DRAWING BY A PLS WHICH SHOWS THE SEWER LINE AND CLEANOUT LOCATIONS 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 Garness Engineering Group, LTD. (GEG) Phone Engineer's Printed Name Jeffrey A. Gayness Date _ In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an aftemative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 907-337-6179 n f Go ess. 4� CE—1, :UCENSE ,rofes ion°o #AECCW4 iA