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
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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
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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