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HomeMy WebLinkAboutT13N R3W SEC 13 LT 38 N75' OF S150' T13N R3W SECTION 13 LOT 38 N75' of S150' #006-043-07 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING, LAND & WATER Alaska Hydrologic Survey WATER WELL LOG Revised 08/18/2016 Drilling Started: ____/____/______ Completed: ____/____/_______ Pump Install: ____/____/_______ City/Borough Subdivision Block Lot Property Owner Name & Address Well location: Latitude Longitude Meridian ____________ Township ______ Range _______ Section _______ , _____ 1/4 of _____ 1/4 of _____ 1/4 of _____ 1/4 BOREHOLE DATA: (from ground surface) Suggest T.M. Hanna’s hydrogeologic classification system* https://my.ngwa.org/NC__Product?id=a185000000BYub3AAD Depth From To Drilling method:  Air rotary,  Cable tool,  Other Well use:  Public supply,  Domestic,  Reinjection,  Hydrofracking  Commercial,  Observation/Monitoring,  Test/Exploratory,  Cooling,  Irrigation/Agriculture,  Grounding,  Recharge/Aquifer Storage,  Heating,  Geothermal Exploration,  Other Fluids used: Depth of hole: __________ ft Casing stickup: ___________ft Casing type: __________ Casing thickness: _________ inches Casing diameter: _________ inches Casing depth: __________ ft Liner type: _________ Depth: _____ ft Diameter: _____inches Note: Well intake opening type:  Open end,  Open hole, Other Screen type: _________, Screen mesh size: ____________ Screen start: ________ ft, Screen stop:________ ft, Perforated  Yes  No Perforation description: Perf from: ________ ft, Perf to: _______ft, Perf from: ________ ft, Perf to: ________ ft Gravel packed  Yes  No Gravel start: ______ ft , Gravel stop:______ ft Note: Static water (from top of casing): _______ ft on____/____/_____ Artesian well  Pumping level & yield: ______ feet after _____ hours at _____ gpm Method of testing:__________________________________________ Development method:______________ Duration: ____________ Recovery rate: _________ gpm Grout type: _________________ Volume __________________ Depth: From ___________________ft, To ___________________ft Final pump intake depth: __________ ft Model: _______________ Pump size: _____________ hp Brand name: __________________ Include description or sketch of well location (include road names, buildings, etc.): Was well disinfected upon completion?  Yes  No Method of disinfection: Was water quality tested?  Yes  No Water quality parameters tested: Well driller name: .................................................................................. Company name: ................................................................................... Mailing address: .................................................................................... City: __________________________ State: AK Zip: ___________ Phone number: (________) ________- ______ Driller’s signature: Date: ______/______/_________ Anchorage Municipal Code 15.55.060(I) and North Pole Ordinance 13.32.030(D) require that a copy of this well log be submitted to the Development Services Department/City within 30 days of well completion. City Permit Number: _____________________________ Date of Issue: _____/____/_________ Parcel Identification Number: ______-_______-________ *Guide for Using the Hydrogeologic Classification System for Logging Water Well Boreholes by Thomas M. Hanna NGWA Press AS 41.08.020(b)(4) and AAC 11 AAC 93.140(a) require that a copy of the well log be submitted to the Department of Natural Resources within 45 days of well completion. Well logs may be submitted using the online well log reporting system available at: https://dnr.alaska.gov/welts/ OR email electronic well logs to dnr.water.reports@alaska.gov North n -149.730296 013N NE003WNE n 38 n Municipality of Anchorage 13 6 61.22177199999999 LEWIS ERHART , 30 n S 12953 SW T13N R3W SEC 13 SWAFFORD DRILLING NW 3 1959 n 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. 006-043-07-000 Expiration Date: Legal description T13N R3W SEC 13 LT 38 N75' OF S150' Site address 232 GRAND LARRY ST Anchorage AK 99504 Current property owner(s) KING DAVID A & BONNIE J 1/15/2025 X The On-site system(s) is/are approved for 2 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 1/24/2024 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 Arsenic Advisory Other COSA Approval June 2022 11 1' LI U V � C � P 11 L ll Y 0 /\ N C H0 u/\ IF Development Services De artment 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. 00604307000 Complete legal description T1 3N R3W Sec 13 L38 N75' of S150' Location (site address) 232 Grand Larry St. Current property owner(s) David & Bonnie King 2. ON-SITE SYSTEMS SIZED FOR 2 BEDROOMS Day phone 907-244-7176 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 - 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 $ 2 cX,, Waiver Fee $ Date of Payment I tz 10 2 Z y Date of Payment COSA # 05C,211 I COG Waiver # COSA Application—June 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: 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 Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade 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 Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed 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 Comments/Deficiencies: 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' QYes if No ft DYes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' ❑Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' FEI Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑ Yes if No ft ft ft ft ft 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 Walden Construction & Cons. & En:~., LLC. Phone 907-354-6661 Engineer's Printed Name Robert Walden COSA Checklist June 2022 Date 1/17/24 ❑ Yes if No ft Community Sewer Main > 75' DYes if No ft Manure/Animal Excreta Storage > 100' Q Yes if No ❑ 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' ❑ Yes if No ft Surface Water> 100' [:]Yes if No 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 Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No Water Service Line > 10' ❑ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS ft ft ft ft 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 Walden Construction & Cons. & En:~., LLC. Phone 907-354-6661 Engineer's Printed Name Robert Walden COSA Checklist June 2022 Date 1/17/24 FRUI? ;t a� al A 12 E 1/2 lie KIP 1/4� of tbvl k 1/4 elm ­ k3j fss 81= ]?Ortl4ll of BLU let 38, SeotlaR 13. To hfp 13 North. liexsge 3 West. S.U. PFDNE- M7. : 5626040 ' 1 Jan. 23 2001 03: SAM P2 d7.WJAeC Scull f beh - JD F*ot ,70717067— 7.5 1 b js 5p Poll., COLDWEU BANNERS Date — Scale redsl Descriptor► 1-19-01 1" = So• LartMark Lot is Black s- � 2ID105 M LEGAL ABOVE 0"0 Va-gusrd �—. Suite 203 ( ) dnchoraCe, AAask>r 99507 s7ia 73 �� fie 603 SUBDMSION (007) 662--6050 It D/RMW D r o ar stvwrttfy tA.at t6o gFapertTt tae ii✓5pr ho tBCB Sitaatood tYsr�re�on 9 sal 4imctivn, as thhea arc a t�� linea do 1�' � Nk � grop sxd not a'�14p or 4neraach da the Propt� bine IWIP11m thereto Uni"a orherwirc uh0ua. Itat r no lmprv+cmaata on Lts4 ptap 9 adjarcnt thereto tmer+oaeh en the promievs is on #hat thtr� `0- +� qll wad are ssn roaaa". tr&mc miesion linea or other easeniouts an said pmpext7 =c-ept aA shown. It to the rraPom abMty of the owu.r or wilder, prior 44 oanstry¢ttaq, to verify prop v" bulldtisg gr;da relative to finiah grade and utfatty �»�wo>zo aba to datarxfai>4 the cxlztYnce of aup e.aements, ❑orowzts, mvtr"one -hieh do hPt appser on tzl* raearde.l s:LiAdlvl>?1073 plat IW T >t avrcarrr 7.s-aaea of i i7ted dlotamo� pMVAff otcr BGAliT1g. 'F;eproduotian iJ7al cause Q7atorlioa. +to AV o�gA1 # � ����-� (71)1]0] "Vd ZS:LT rooz/zT/so Name: Brandon’s On Site: BOS 23-203 Lab ID#: M231189 Mailing Address: 3924 N. Greywolf Drive Date Sampled: 12/07/2023 Wasilla, AK 99654 Time Sampled: 11:00 Legal Description: T13N R3W Sec 13 L38 N75’ of S150’ Sampled By: BLJ/BOS Sample Site Location: Bathroom Sink Date Received: 12/07/2023 Time Received: 12:30 Health Guard I Parameter Method Result Unit MRL MCL Date Total Coliforms Colilert (SM 9223B) P --- --- --- 12/08/2023 E. coli Colilert (SM 9223B) A --- --- --- 12/08/2023 Nitrate/Nitrite – N TNTplus 835/836 (Hach 10206) 0.356 mg/L 0.200 10.0 12/13/2023 Arsenic Arsenic by EPA 200.8 <MDL µg/L 1.000 10 12/18/2023 Method Reporting Limit (MRL): the lowest concentration that can be reported reliably Maximum Contaminant Level (MCL): highest acceptable level in public water systems as set by EPA mg/L: milligrams per liter; 1/1000th of a gram µg/L: micrograms per liter; 1/1,000,000th of a gram Absent (A): none of this type of bacteria was detected Present (P): one or more bacterial cells of this type were detected Results Reported By: _____________________________ Patience Obermann Laboratory Analyst Reviewed By: 9131 E Frontage Rd, Ste 15 Palmer, AK 99645 (907)745-3005 matsutestlab.office@gmail.com Juliana Smit (Dec 20, 2023 08:43 AKST) Juliana Smit P \ / LLC \ )� v Midtown Community Business Park 9131 East Frontage Road, Suite 15 Palmer, Alaska 99645 Phone: 745-3005 / Fax: 745.3010 Website: www.matsutestlab.com E -Mail: matsutestlab.otrice@gmail.com Drinking Water Analysis Report Total Coliform Bacteria (SM92238 by Colilert) B.O.S. BRANDON'S ON-SITE SERVICES LLC Z 3 ' ZD w fi: 3924 N Greywolf Drive, Wasilla, Alaska 99654 _ PUBLIC WATER SYSTEM (PWS) ID#: : Bill: (907) 355-3987 N/A _••Information needed for DLC. Irnnl YJnf monitonnn swwmnry­, _ _Fa_cility_I_D Fax: Sample Pt. ID: Email: brandonsonsite@gmail. Hard copy (To be mailed to address ,ClResidual(if applicable): ,� _v �� a r••.-.;4 (LE.: bathroom sink, outside hose bib) ___7 H � ::-e pl i'-�,�r i Rill'^a\"�:' '.l°i5 ✓'Y' .�iY� r Routine Test / Rept4pest I Special Purpose] This Section to Be Completed by Lab Analysis Results: 6240159 Lab ID #_ _ Satisfactory Unsatisfactory OSample Rejected — Reason: Chromogenic/Fluorogenic Method Results: INCUBATOR# I —� %�- Total Coliform Present (P)/Absent (A) ( Yellow / Color E. Cali Present (P)/Absent (A) ( Fluorescence / o�uorescence I Received : p. JAN 15 2024 y7 By: Started : )JAN 15 2024, 6(001 By: s5 Finished JAN 16 2024 1601 By: ANCHORAGE WELL & PUMP SERVICE, INC. 7640 KING STREET ANCHORAGE, AK 99518 PH. 907-243-0740 Invoice Invoice #:20240197 Bill To: Bonnie King PO Box 670089 Chugiak, AK 99567 Ship To: Bonnie King JOB: 232 Grand Larry St Anchorage, AK 99504 SALESPERSON RIDGWAY, TYLER S YOUR NO. 37861 SHIP VIA COL PPD SHIP DATE TERMS Net 30 DATE 1/10/2024 PG. 1 QTY.ITEM NO.DESCRIPTION PRICE DISC %EXTENDED PRICE TX. We appreciate your business. Thank you!SALE AMT. FREIGHT SALES TAX TOTAL AMT. PAID TODAY BALANCE DUE Scope of Work:UP GRADE WELL CASING TO MOA CODE, PUT WIRE IN CONDUIT, AND INSTALL NEW SANITARY SEAL. $0.00 $0.00 1 Field Service 12/11/23 - Site visit to take pictures for casing extension. $258.00 100%$0.00 0.5 ST5-Tyler Service Tech $0.00 $0.00 0.5 ST9-Service Tech Helper Service Tech Helper - Tallon $0.00 $0.00 1 Field Service 12/26/23 - Remove pump, pressure tank and piping from under stairs for excavation work. $2,193.00 $2,193.00 ST2-Mark Service Tech $0.00 $0.00 1 ST6-Henry Service Tech $0.00 $0.00 1 Field Service Check system. Install well aapter sleeve and upgrade well casing. Install sanitary seal and hook up jet pump back to distribution plumbing. Prime pump and test. Shock chlorinate well outside and inside. $0.00 $0.00 3 ST5-Tyler Service Tech $0.00 $0.00 3 ST2-Mark Service Tech $0.00 $0.00 1 PARTS:CUSTOM 4"X6" STEEL ADAPTER $100.00 $100.00 1 PARTS:4" GALVANIZED COUPLING $80.00 $80.00 1 WELL CASING 4" GALVANIZED PIPE $109.00 $109.00 1 PARTS:4"X1" SINGLE PIPE WELL SEAL SPLIT TOP $75.00 $75.00 1 FIT-PVC-WVT-.5 WELL VENT-.5" NPT WELL SEAL VENT $30.00 $30.00 1 FIT-BRS-BSH-.75X.25 BUSHING-.75"X.25" BRASS NO LEAD $8.00 $8.00 1 FIT-BRS-PLG-.25 PLUG-.25" BRASS NO LEAD $4.00 $4.00 5 PARTS:1" PEX 90*$8.00 $40.00 4 PARTS:.75" PEX 90*$6.00 $24.00 1 PARTS:.75" PEX X MALE ADAPTER BRASS $12.00 $12.00 ANCHORAGE WELL & PUMP SERVICE, INC. 7640 KING STREET ANCHORAGE, AK 99518 PH. 907-243-0740 Invoice Invoice #:20240197 Bill To: Bonnie King PO Box 670089 Chugiak, AK 99567 Ship To: Bonnie King JOB: 232 Grand Larry St Anchorage, AK 99504 SALESPERSON RIDGWAY, TYLER S YOUR NO. 37861 SHIP VIA COL PPD SHIP DATE TERMS Net 30 DATE 1/10/2024 PG. 2 QTY.ITEM NO.DESCRIPTION PRICE DISC %EXTENDED PRICE TX. We appreciate your business. Thank you!SALE AMT. FREIGHT SALES TAX TOTAL AMT. PAID TODAY BALANCE DUE 9 PARTS:.75" PEX RING CLAMP $2.00 $18.00 CONTINUED ON PAGE 2 CONTINUED FROM PAGE 1 10 PARTS:1.0" PEX RING CLAMP $2.00 $20.00 1 PARTS:TRACTION SAND $10.00 $10.00 1 BENTONITE BENTONITE-3/8 HOLE PLUG 50LB BAG $45.00 $45.00 1 PARTS:CHLORINE $9.00 100%$0.00 1 RENTAL WELDER RENTAL $175.00 $175.00 8 FIT-PVC-PEX-TBG-.75 TUBING-.75" PEX BLUE $2.00 $16.00 $2,959.00 $0.00 $0.00 $2,959.00 $0.00 $2,959.00 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section (On-site) Fax: 907-343-7997 Mailing Address: P.O. Box 196650 • Anchorage, Alaska 99519-6650 • http://www.muni.org To whom it may concern, The well for the property described as T13N R3W Section 13 Lot 38 N75’ of S150’, or 232 Grand Larry St. Anchorage, Alaska 99504 was drilled in 1959 to a depth of 30+ feet. Over the last 12 years there have been 4 Code Enforcement cases relating to illegal auto repair and auto wrecking taking place on the subject property. In each of these separate cases a great deal of automotive fluids (motor oil, antifreeze, transmission fluid, etc.) were seen to have been dumped/spilled onto the ground in the front, rear, and side yards. This soil contamination could possibly migrate into the water table that is serving the well on this property. The MOA only requires water testing for Nitrates and Arsenic to complete the COSA process but would recommend that this shallow well be tested for hydrocarbons and other contaminates that may have been released from the automotive repair/wrecking activities that have taken place at this location. Sincerely, Ben Cogger Municipality of Anchorage On-Site Water & Wastewater Section