HomeMy WebLinkAboutSKY RIDGE LT 15• 7;�j #--u 1%0 1 am e. www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: OSP 241023 Date of Issue 3/22/24 Parcel Identification Number: 01527515000 Legal Description Property Owner Name & Address Sky Ridge LT 15 Hultquist Homes 11088 Sky Ridge Dr. Anchorage, AK 99516 Pump Installation Date: 3/21/2024 Pump Intake Depth Below Top of Well Casing: 212 feet Pump manufacturer’s Name: Grundfos Pump Model: 10SQE07-240 Pump Size: 3/4 hp Pitless Adapter Burial Depth: 12 feet Pitless Adapter Installer: Hultquist Homes Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Certified Drilling Log OWNER OF LAND: Hultquist Homes ADDRESS: 11088 Sky Ridge Drive. Anchorage, AK 99516 LEGAL DESCRIPTION SKY RIDGE LOT 15 DATE: 3/22/24 PERMIT NUMBER: OSP241023 DATE OF ISSUE: 3/22/24 TAX IDENTIFICATION NUMBER 01527515000 Is well located at approved permit location: Yes No Method of Drilling: air rotary cable tool Depth of Well: 224’ Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 224 feet Liner type Static Water Level: 86 feet Recovery Rate 15 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: 100 lbs. Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: yes no Method of Disinfection: Chlorine 50 PPM Comments: Bore Hole Data Depth From To 0 2 Casing Stickup 2 4 Overburden 4 15 Gravel 15 18 Sand 18 38 Silt and gravel 38 50 Gravel/Silt 50 55 Silt 55 58 Silt/Clay 58 70 Silt 70 78 Silt some gravel 78 93 Silty sand 93 105 Silt some gravel 105 118 Silt/Gravel 118 138 Silt clay some gravel 138 158 Silt some gravel 158 178 Silty sand some gravel 178 224 Silt/Gravel 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. MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water System Permit Permit Number: OSP241023 Work Type: Well Initial Tax Code Number: 01527515000 Site Legal Address: SKY RIDGE LT 15 G:2634 Site Mailing Address: 11088 SKY RIDGE DR, Anchorage Owner: HULTQUIST HOMES INC Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date: `S' V � l )�eI)aYtnicnt Lot Size in Sq Ft: Total Bedrooms: 3/22/2024 3/22/2025 20120 ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy 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 Received By: S `A�ja t/- tS Date: Issued By: Date: 5 ZZ-'70 2 `/ 4 d hOUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON -SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-275-15 Property owner(s) HUltquist Homes, Inc. Day phone _ Mailing address 12570 Old Seward Highway Anchorage, AK 99515 Site address NHN Sky Ridge Drive Legal description (Sub'd., Block & Lot) Sky Ridge Lot 15 Legal description (Township, Range & Section) Lot Size 20,120 Sq. Ft. Number of Bedrooms M APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial X❑ Single Family (SF) X❑ Septic Tank ❑ Upgrade ❑ (w/wo ADU) Duplex (D) ❑ Holding Tank El Renewal El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well X❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Is �P (Signature of property owner or authorized agent) Permit/Rush Fees: Z Z 5- Date of Payment: 2- Ae _ `1 Receipt Number: 614 1 (5- Permit No. 050 Z % 42 Waiver Fees: Date of Payment: Receipt Number: Waiver No. Permit App_ - : . _.,:c r �> Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. O. Box 196650 Anchorage, Alaska 99519 Subject: Sky Ridge Lot 15 Well Permit Request Well Design Narrative Municipality of Anchorage On -site Water and Wastewater REVIEWED FOR CODE COMPUANC OSP241023, Curtis Townsend, 03/26 26 February 2024 This is a design narrative for a permit to install a private well for this property. Currently the lot is undeveloped. This lot and the surrounding lots are to be served by public sewer. Currently there are no sewer mains or private septic systems within 100' of the proposed installation. 1. Initial Well Design. The well will be located 100'+ from any sewer main. 100'+ from any on -site septic system. 25'+ from any private sewer lines. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at (907) 745-8200. Sincerely, S F�__P Steven R. Pannone, PE, F. ASCE Owner/Civil Engineer Mailing: P.O. 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Q7 Q� c�, 3 O Z t,��Olns��� W I (� W W III - \ "�\ m0.Re Lot 15, Sky Ridge Subdivision As Built Land Surveying Land Development Consultants Subdivision Specialists Construction Surveying AEC# 173042 S4 Group 124 E 7th Avenue Anchorage, Alaska 99501 (907) 306-8104 mail@S4AK.com 08/15/2024 Itr- O CD 0') 0') C'7 C") IZT T C? I? rl-r— O O OD CD a) j LL LU 0 V a- NQN LCL O 2 U Z LL`. \� 0 � 0 /Q /1 U Q Z DU)o U L a) U c E� Q o > (/) (1) c MiM LO N O N N cY) 6 cu C O cu a- x X LU O O O 1 LO r 1 LO 1 N LO 1 0 a) U c4 a_ r LO 0) Q a) co O J_ - Lr) LO r J LU w p � Y U) /Yn � 00 coO c o r- U) U In U o -0 .O "O -Fu CU a) a) J U) Awl U) W O 2 F— CO 0 J 2 a) O if aD CL O Q U DOE 0 a) O a a co a) c`a Ln E U) U) a) O a) x 0 c0 O CL CL cu O c O E O W :1 L) o`` 0 C 0 U) a) L Q. 'v G 4) M cC CL c O 3 v, L ++ 0 O O C v O. 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(n 0) El rn a) O r 3 m a LL > ch a) V, Elcn Uc) � T W Q N C O F1> El a) U) o c a — a = c 'a o W a) m ElU O m m CL o CL C13 (D a) U) J ❑ ElOL CL O �I '— L > U) N O cn a) _ t Y_ Q, _N a) J ❑ ¢❑ C W L E a) a ElLD N Q Cl) U) ?� U) aa) y 2 w Wa) ❑ W N v W W F- Q) LL a) L Z0 2� 2� O u U) Q N 4--M F- O O U a- LU w a)cn O T y+ a a O H W Q CO > `m ��- in Q N M �t L6 CC > W m� m m U - aa)) m i i m v./ 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: COSA Checklist_June 2022 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’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ 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’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC & MOA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water 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 system. All systems eventually fail, and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore, we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Phone Engineer’s Printed Name Date www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: OSP 241023 Date of Issue 3/22/24 Parcel Identification Number: 01527515000 Legal Description Property Owner Name & Address Sky Ridge LT 15 Hultquist Homes 11088 Sky Ridge Dr. Anchorage, AK 99516 Pump Installation Date: 3/21/2024 Pump Intake Depth Below Top of Well Casing: 212 feet Pump manufacturer’s Name: Grundfos Pump Model: 10SQE07-240 Pump Size: 3/4 hp Pitless Adapter Burial Depth: 12 feet Pitless Adapter Installer: Hultquist Homes Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Certified Drilling Log OWNER OF LAND: Hultquist Homes ADDRESS: 11088 Sky Ridge Drive. Anchorage, AK 99516 LEGAL DESCRIPTION SKY RIDGE LOT 15 DATE: 3/22/24 PERMIT NUMBER: OSP241023 DATE OF ISSUE: 3/22/24 TAX IDENTIFICATION NUMBER 01527515000 Is well located at approved permit location: Yes No Method of Drilling: air rotary cable tool Depth of Well: 224’ Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 224 feet Liner type Static Water Level: 86 feet Recovery Rate 15 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: 100 lbs. Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: yes no Method of Disinfection: Chlorine 50 PPM Comments: Bore Hole Data Depth From To 0 2 Casing Stickup 2 4 Overburden 4 15 Gravel 15 18 Sand 18 38 Silt and gravel 38 50 Gravel/Silt 50 55 Silt 55 58 Silt/Clay 58 70 Silt 70 78 Silt some gravel 78 93 Silty sand 93 105 Silt some gravel 105 118 Silt/Gravel 118 138 Silt clay some gravel 138 158 Silt some gravel 158 178 Silty sand some gravel 178 224 Silt/Gravel 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. Lot 15, Sky Ridge Subdivision As Built Land Surveying Land Development Consultants Subdivision Specialists Construction Surveying AEC# 173042 S4 Group 124 E 7th Avenue Anchorage, Alaska 99501 (907) 306-8104 mail@S4AK.com 08/15/2024