HomeMy WebLinkAboutCANYON VIEW ESTATES BLK 1 LT 11Estates-
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www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: OSP 241041 Date of Issue 3/27/24
Parcel Identification Number: 02102144000
Legal Description Property Owner Name & Address
Canyon View Block 1 Lot 11 Hultquist Homes
13837 Canyon Road Anchorage, AK 99516
Pump Installation Date:
9-18-24
Pump Intake Depth Below Top of Well Casing:
192 feet
Pump manufacturer’s Name:
Grundfos
Pump Model:
10SQE10-290
Pump Size:
1 hp
Pitless Adapter Burial Depth:
12 feet
Pitless Adapter Installer:
Pitless Manufacturer:
Red Dog
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
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.
Merrill
Certified Drilling Log
R DOC CO dba
BILL 8. COLE
;400" ULLIVAN WATER WELLS
P.O. Box 670269, Chugiak, AK 99567 688-2759
OWNER OF LAND: Hultquist Homes
ADDRESS: 13837 Canyon Rd. Anchorage, AK 99516
LEGAL DESCRIPTION Canyon View B1 L11
DATE: 8/30/24
PERMIT NUMBER: OSP241041 DATE OF ISSUE: 3/27/24
TAX IDENTIFICATION NUMBER 02102144000
Is well located at approved permit location: ®Yes ❑No
Method of Drilling: ®air rotary ❑cable tool
Depth of Well: 220'
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 44 feet
Liner type
Static Water Level: 93 feet
Recovery Rate 50 ® 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: 350 lbs
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: ®yes ❑ no
Method of Disinfection: Chlorine 50 PPM
Comments:
Shallow bedrock Surface Seal per MOA Code
Bore Hole Data
Depth
From
To
0
2
Casing Stickup
2
4
Overburden
4
8
Tight silty sand and gravel with
cobbles
8
21
Hardpan
21
24
Broken bedrock yellow
24
49
Hard gray bedrock
49
56
Bedrock yellow
56
124
Bedrock gray
124
137
Bedrock gray with quartz
137
185
Bedrock gray
185
220
Bedrock highly fractured
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
�»cnt
On -Site Water & Wastewater Program �� ,y�,7,Y1 fIs,
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 �� n
http://www.muni.org/onsite
Depai-nuent
On -Site Water & Wastewater System Permit
Permit Number: OSP241041 Effective Date: 3/27/2024
Work Type: WellSeptic Initial Expiration Date: 3/27/2025
Tax Code Number: 02102144000
Site Legal Address: CANYON VIEW ESTATES BLK 1 LT 11 G:3042
Site Mailing Address:
Owner: HULTQUIST HOMES INC Lot Size in Sq Ft: 66896
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4
This permit is for the construction of:
Q Disposal Field Q 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-� � s 'i"o fJ
Issued By:
Date:
Date: 2 -7 2
MUNICIPALITY OF ANCHORAGE
t�,��
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
E
ON-SITE SEWER/WELL PERMIT APPLICATION'
Parcel I.D. 021-021-44
Property owner(s) Hultquist Homes INC Day phone
Mailing address 12570 Old Seward Highway Anchorage, AK 99515
Site address NHN Canyon Road
Legal description (Sub'd., Block & Lot) Canyon View Estates 131 L11
Legal description (Township, Range & Section)
Lot Size 66,896 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Fieldx❑
Initialx❑
Single Family (SF) ❑x
Septic Tank
❑x
Upgrade ❑
(w/wo ADU)
Duplex (D) ❑
Holding Tank
❑
Renewal ❑
Multiple Dwellings ❑
Privy
❑
1 (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.
W.94
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number:
Permit No. 0 SP Z i/ p f
Permit App_'-'-:- .'_. c
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
Mailing: P.O.Box 1807, Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Alaska
Subject: Canyon View Estates B1 L11
Well and Septic System Permit Request
Design Narrative
This is a design narrative for a permit to install an initial well and septic system on the subject property. The
proposed system will serve a proposed four-bedroom (4) house. This lot and surrounding lots are served by private
wells.
1. Soils:
A test hole was performed on this lot by Pannone Engineering Services, LLC on 03 October 2019, the hole was
extended to a depth of 16 feet on 07 October 2020. Groundwater was not observed during the excavation of the
test hole, and bedrock was not encountered. Groundwater was observed in the test hole monitor tube at a depth of
1.0ft BGS on 27 May 2020. The soils log from the subdivision report is attached for reference. Based on the results of
the percolation test and overall soils appearance an application rate of 6.0 gpd/SF was used for the design of an
advanced (CAT III) wastewater treatment system in the area of the test hole.
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water:
There is no surface water within 100 feet of the proposed septic tank and drain field. As defined in AMC 15.65
4. Topography:
See attached site plan for area topography.
5. Drawing Markings: The Drawings are marked “For MOA Review Only”. When written notification that the
review is complete and no further comments are received from MoA On-Site Department, the note will be removed
and “For Construction” drawings will be issued.
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,
SRP
Steven R. Pannone, P.E. F. ASCE
Owner/Civil Engineer
21 March 2024
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241041, Deb Wockenfuss, 03/27/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241041, Deb Wockenfuss, 03/27/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241041, Deb Wockenfuss, 03/27/24
1
2
3
4
5
6
7
8
9
1 0
11
12
13
1 4
1 5
16
TH11
DEPTH TO WATER
OR TOPSOIL
DRY
N 7
27M
11 OCT19
SAND &
GM/ SM GRAVEL W/
1.0'
FRACTURED
27MAY20
ROCK
GM/ SM
SILT Y SA N D Y
GRAVEL W/
FRACTURED RO(
SM/ M L SILTY SAN D Y
GRAVEL W/
F R A C T U R E D R O C K
AN G ULAR
COBBTIGHT W/
ATTIGHT SAND
SILT
BOH
DATE PERFORM ED: 03O C T19
HOLE EXTENDED: 07 0C T 2 02 0
SOILS LOG - P ERC O LATIO N TEST
S L O P
TEST
HOLE
v
I
SITE P LA N 11
I
I
N
WAS GROUND WATER
ENCOUNTERED? N
IF YE S, A T W HAT
D E P TH? — N A —
DEPTH TO WATER AFTER
M O N IT O R IN G ?DRY
D ATE :11 OCT19
DEPTH TO WATER AFTER
M O N IT O R IN G ?1. 0'
DATE:27MAY20
COMMENTS: Test hole excavated by WHITE RAVEN
PERFORM ED BY: PES. I CERTIFY THAT THIS TEST
W AS P E RFO RM E D IN AC C O RD AN C E W IT H ALL STATE A N D
M U N IC IP A L G UID LIN E S IN EFFECT O N THE DATE OF THIS TEST.
N O T E S:
SO ILS REP O RT
D RAW N I JRL
SO ILS LOGS
I
i
1
SLO PE
TH 1
SOIL TEST RESULTS/ AN ALYSIS
P E R C O LATIO N R ATE 3. 1 m p ft i n /inch )
Hydrologic Soils Group: HSG A)
PERC HOLE DIAM ETER 6"
TEST RUN BETW EEN 2 FT A N D 3 FT.
TEST RUN FOR OVER AN HOUR, LAST
THREE READ ING S PRO VIDED.
RE AD IN G D ATE NET TIME
W ATER
LE VE L
RE AD IN G
N E T DRO P
RATE
M PI)
1 03 O C T 1 9 5. 9 00"
2 10 MIN 9. 5 6 0"3. 6 6 " 2. 7
3 5 . 9 00"
4 10 M IN 9. 110"3 . 21" 3. 1
5 5 . 9 00"
6 10 MIN 1 9. 080" 3 . 18" 3. 1
PANNONE ENG SVC, LLC
P. O. BOX 1807 PALMER, AK 99645
PHONE ( 907) 745- 8200 FAX ( 907) 745- 8201
CANYON VIEW ESTATES, B LO C K 1, LO T 11
SITE: C AN YO N RO AD
AN C HO R AG E , AK
D a te
04 / 16/ 2 02 1
Scale
N TS
P. I. D. NO
PERM IT NO.
S 1 2 5 4 5
Sh e e t
17 OF 3 4
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241041, Deb Wockenfuss, 03/27/24
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this 21st' Day of C/ of 2021 , by and between
herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Advantex System
located at (legal description)
Canyon View Estates B1 L11
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
61LOwner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
/ guidelines for the construction, maintenance and repair of the Owner's AWWTS.
6WOwner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. .Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER:
By: (signature) Date: off/ a
(print name)
Pa!g x v ill- HCW14
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this 2051 day of PVk&(A_
20-24 , by ('Ll(AU NUl$ U V,Ist4 Vl CL pvtfi cuhfi 6 �t'KiUl vi Sfi
S -
NOARY PUB IC OR ALA 'A STAM OF ALASKA
My Commission , fires: �jZZ j20Z Q NOTARY PUBLIC
Ashlee LaVigne
;ch
9
MUNICIPALITY:
By: _(signature)
(print name)
(rev. 05/18/2018)
Date: c
Title:
Page 3 of 3
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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:
9/26/2024
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.
Name of Firm Phone
Engineer’s Printed Name Date
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND
AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this CP Day of er' of 20,PL by and between
— 112VQ. Taboy1 herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as AN ADVANTEX SYSTEM
located at (legal description)
Canyon View Estates L11 B1
2. Maintenance. Repairs and Alterations.
Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AW WTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AW WTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
I accordance with the equipment's approval for operation in the Municipality.
( C It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
64 Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
1 — Owner acknowledges that regular maintenance of an AW WTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Pagel of 3
u^� Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
1 Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
1k Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
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Lot 11, Block 1,
Canyon View Estates 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
09/16/2024