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HomeMy WebLinkAboutEAGLE ROCK LT 25DEagle Rock Lot 25D #075-092-71 lVatcr lvd-r Drilling and Pump Service n:(w•raw. A(,u(a (6)07) 345-0593 Cita'Uornugh. Suldrcl.ion: Girdwood Eagle Rock MAXI: 'Township flange_ BOREHOLE DATA(from top of casing)Depth Material: 'Type. Color & wetness I mm To stickup gravel w/ clay silty gravel wet silty clay & gravel moist clay & gravel dry silt w/cobbles & gravel moist silt & gravel Well Log urdltng sorted. 0.8 11, 2008 completed: 08. 12 2008 Property °"tier Nantc A Address: Douglas K. Reynolds 6220 Austin Ave. Site: 128 Wadonia Way Anchora.e, AK 99518 Section % of Drilling method: (X ) Air rotary. ( 1 Cable tool. Other Well use: ( 1 I'uhlic supply. ( x ) Domestic. Other __—__ - Depth of hole: 105 1i, Casing stickup: ? fi — Casingtypc:steel _ _ Thickness: _:250 Inches Casing diameter: 6 inches Casing depth: ___ 1OS ft Liner type: Diameter: =_inches Depth:= p Static water (from top of easing): 74 ti on pa, 12 '2008 Pumping level & yield: __ feet after _ hours at gpin Reco%cry rate: 15 gpm. Method of testing: airlift De%elopmcnt method: airlift Duration: 1 hour Kell intake opening tsps: (X) Open end. t ) Open hole. Other Screened: Start: - fi. Stopped - __ rt Screen type: Slotaneslt size: - Pcrl'nrated: Stan: - 0. Stopped: _-- -- ft Stan: - 11. Stopped Grout f)pe: __ bentonite volume Depth: from _grour1d sUrrce . to Pump intake depth: Pump size: hp. Brant name: i Was well disinfected upon completion! ( X ) Yes. ( ) No Method ofdisinfcction:CalCiUm.IH •.. Driller conunents'disclaimers: hlOrde..(CI1101.7ne) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Sect ion 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907)343-7904 Well driller name. Jobnay Company name: Hefty Drilling, Inc. Mailing address- 3540 Akula Dr. cit.: _Anchorage Phone number : ( 907 345 _ 0593fax:345-4700 Driller. signature: ttention: Prope owner shall provide a well log to the DSD within 60 days of well completion. Permit Number: SW080140 Date of lssue: slid 23L2008— Parcel Identification Number: Is well located at approved permit Iowuioti! ( X) Yes or ( ) No Pities* Adapter Manufacturer's Name: Conch it 5—jay Pities* Adapter Installer. Ked,iad !l STRIAI p PAM flRotor ONOP TYPE: Two L� PVC_ I't omen Ponta OWE: T /"r & &_ L_ 10. %.1. Conatica/t1,t fl aztlmcK: van .23 1.I MATER TAW: hp, Wt1I Lira' loQ y.(l sal Mal CAC Sin G., Din Tips 5 Cvl CASED ME: Tram/( ' Tot WAKE njci SME: TSP. On c h 6/14 horn !� To well was disinfected upon completion. method: calcium hypochlorite. Water weir and PLm y, Service !Anchorage, MasI a (907) 345-0593 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343.7904 ON-SITE WATER SUPPLY PERMIT Initial Permit Number: SW080140 Legal Description: EAGLE ROCK LOT 25D Design Engineer: 0000 ZZ - NONE NEEDED Owner Name: DOUGLAS K. REYNOLDS Owner Address: 6220 AUSTIN AVE ANCHORAGE , AK 99518 - Date Issued: Jul 23, 2008 Expiration Date: Jul 23, 2009 Parcel ID: 075-092-71 Site Address: 128 WADONIA WAY Lot Size: 16749 SQ. FT. Total Bedrooms: 0 Permit Bedrooms: 0 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage All construction must 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: firc—CenA-- Date: ! G `Y -c2 lli[)Z6^ Date: Parcel I.D. T n Property owner(s) D, J • M5 .• g 144 / Mailing address76e. 2-2o .Ad s t7n Apt A+•ely iht , Site address / 18 GI/aalon 4 W Zip Code Legal description (Sub'd, Block & Lot) • LP T ,L 2 -CP i ra`1 /c, 2p-b/L So b Legal description (Township, Section & Range) r G'frcJiva o L /NC_. Number of Bedrooms Municipality of Anchorage Development Services Department - Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING bis -b9,2- 7I Day phone 9o7— 562— ip,ZZ Zip Code 99517, Lot Sized c7 Sq• Ft, THIS APPLICATION IS FOR (®all that apply): Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage THIS APPLICATION IS AN: Initial Upgrade Renewal I certify that the above information is correct. I furthercertify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal (Signatur f property owner or authorized agent) Permit/Rush Fees: 11 Date of Payment:11$108 Date of Payment: Receipt Number. Waiver Fees: Receipt Number: (Rev. 11/05) DEV%LoPGD LoT 2s5 X23.5 FTy �o Prwafe Well Lor conMER r t'nrtinll5 ueueloyeo L.ot 25G No WELL oR SEWF& ye, VJ FT Lot' 1-15-rr Unused Well (CoMMUNLTY) CoaN� ALASKA S TATE [MA. VN DEVEI oPE]) Lor 25/A 5E WER TRUNK L1N C Folz Lo i5 298 156 99Fr / EAGLE Rock SUSD- 26Fr LOT Z S P /4,71/0.7 5. F. <---4"? Pro pos e c) Well 51TF 10FT Lt ;i Scale 1"=ZoFt rr. NEIN tfDME SITE SEWER l-ZNG CLEAN OUT RE5tPEN TIAL. SEWER LLNE OXt5TI N G. ti L 10 Fr, UTILITY /6 9, 33 ,Cr ;propose d YlideK q- sew &r, LOT ZS orA. 0+410 Fa" /6 Potic. Sv D MAN MOLE (SEINER MArN LINE) -� /L.YFSKA MitlAY STA /)Fn/) / .1% ',at., 11 n/ AAI tet- nm.,�l Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 075-092-71 1. GENERAL INFORMATION Complete legal description EAGLE ROCK LOT 25D Expiration Date: 5/7-7-//3 Location (site address) 128 WADONIA WAY, GIRDWOOD, AK 99518 Current Property owner(s) JAY D. FRAWNER Day phone Mailing address 9353 AUTUMN RIDGE ANCHORAGE AK 99507 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class _ Well ❑ Community ❑ Public Water System ❑ Public Sewer El WaiverNariance request for: Distance: Received by: /`(l. s ;-L (4c_t, : COSA to be released to the engineer, unless gtl a r fI4frequested by the engineer. Date: / COSA Fee $ +10 Date of Payment 01/51/ 3 CAp Receipt Number 0 656'1"1 COSA # 05 C -I 10 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. 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 for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Phone 868-3791 Date 2/14/2013 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate dunng the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. 6. DSD SIGNATURE 3 X System #1 Approved for bedrooms. System #2 Approved for, bedrooms. Disapproved. �'Canditionai approval foi 5 bl By: FHII aLro �. Pp1t" AnA3 tS" 4Z 2 O - _m W�SFt,jA�R o. W PRU n. -M �n r11t! .j o1 1j1\�. Original Certificate Date: 3 The Municipality of AncKorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. •y . 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory - .. ' Septic System Advisory Arsenic Advisory Well Flow Advisory Other ‘". COSA blue sheet 10-10-12.doe If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: EAGLE ROCK LOT 25D Parcel ID: 075-092-71 A. WELL DATA Well type PRViIf A, B, or C provide PWSID # _ Well Log (Y/N) Y Date completed 08 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 105 ft. Cased to 105 ft. Casing height (above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test _7123108' B//a / % Dfi.1,-- 216/2013 Static water level 74 i ft. 74 ft. Well production 15 g.p.m. 4.2+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 0.331 mg/L Arsenic: ND ug/L Date of sample: 2/6/2013 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA — PUBLIC SEWER Tank Type/Material Date installed Tank size _ gal. Number of Compartments Cleanouts (YIN) Foundation cleanout (Y/N) Depression over tank (Y/N) High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA — PUBLIC SEWER Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) _ System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) _ For bedrooms Fluid depth in absorption field before test _ in. Water added gal. New depth_ in. Elapsed Time: min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at _ in. "Pump off' level at _ in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot NA Absorption field on lot NA Public sewer main 75'+ On adjacent lots NA On adjacent lots NA Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank NA Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: - PUBLIC SEWER Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: - PUBLIC SEWER Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS Well now output restricted by spigot—it appears well will produce more than the 4.2 qpm stated. G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of determined through field inspections and review of Municipal records that inspections and review of Municipal records that the above systems am in Municipal records that the above systems are in conformance with MOA above systems are in conformance with MOA COSA guidelines in effect on conformance with MOA COSA guidelines in effect on this date. COSA guidelines in effect on this date. on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 02114/2013 COSA brown sheet_10-10-12.doc Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING CosA# 0 l C i BL[ (c) Parcel I.D. 075-092-71 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) REYNOLDS DOUGLAS Day phone 306-1378 Mailing address EAGLE ROCK S/D; LOT 25D Expiration Date: ‘3 -- (- 7 / 128 WADONIA WAY * GIRDWOOD, AK * 99518 Lending agency Mailing address Real Estate Agent Mailing address 6220 AUSTIN STREET * GIRDWOOD, AK * 99518 Day phone LISA HERRINGTON W/ DYNAMIC Day phone 229-6822 3111 C STREET * ANCHORAGE, AK * 99503 Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF°BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System • TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer • The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner fisted above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. Date �747-4>/D 04o6000p‘ ()FA�%44 k1 VA es s... • 0 Q\\ rofession o0 5. DSD SIGNATURE V7 Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: 0tt,: 1. `1/4 • •" •• rte. `kvst t ( OF, Moir, • • ON-SG� • WATER AN:' VSTE:1)TIAETT:: :• PROA • NE�� By: Attachments: COSA Checklist Septic. System Advisory Well Flow Advisory Nitrate A.J.,:...-.r., IVILIaLG ,-UVtaviy Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev. 11/05) Original Certificate Date: / Z. — 7 - / 0 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: EAGLE ROCK S/D; LOT 25D Parcel ID: 0 7S-- ©q 2.- 71 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 7/23/2008 Total depth 105 ft Sanitary seal (Y/N) YES Cased to FROM WELL LOG Date of test 7/23/2008 105 ft. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 24+ AT INSPECTION 12/14/2010 Static water level 74 ft 75 ft, Well production 15 g.p.m. 5.07+ g.p.m. WATER SAMPLE RESULTS: o•35 Coliform colonies/100 ml. Nitrate mg./L. Other bacteria . ' colonies/100 ml. Arsenic: i 3D ug./L. Date of sample:12/14/2010 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK BATA Tank Type/Material Date installed Tank size gal. Number of Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) Depression over tank (Y/N) High water alarm Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (a.p.d./ft2or ft2/bdr r System type Length ft. Width, ft Gravel below pipe ft. Total depth ft. Eff. absorptio - ea ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms in. PUBLIC SEWER Fluid depth in absor• .n field before test in. Water added gal. New depth in. Elapsed 7 -: min. Final fluid depth in. Absorption rate >= g.p.d. rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at in "Pump off' level Datu Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: N/A F. Septic tank/lift station on lot Absorption field on lot Public sewer main N/A 75'+ Sewer /septic service line 25'+ Animal containment areas 50'+ Manhole/Access (Y/N High water alarm level at in Meets alarm & circuit requirements? On adjacent Tots On adjacent lots Public sewer manhole/cleanout Holding tank N/A N/A 100'+ N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: PUBLIC SEWER Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIE • : OT TO: Property line B . oundation Water main Surface water ., Driveway, parking/vehicle storage Water service line Curtalli drain Wells on adjacent lots COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 12- 40/0 COSA Fee $ LVID iC c) Date of Payment 2� 2- l j b Receipt Number Ocp 3 O 171 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SGS SGS Ref.# Client Name Project Name/# Client Sample ID Matrix 1106583001 Garness Engineering Group, Ltd Eagle Rock S/D Lot 25D Eagle Rock S/D Lot 25D Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 12/16/2010 17:10 12/14/2010 11:00 12/14/2010 12:30 Stephen C. Ede Sample Remarks: Parameter Results LOQ Units Method Allowable Prep Analysis Container ID Limits Date Date Init Metals by ICP/MS Arsenic Waters Department Total Nitrate/Nitrite-N Microbiology Laboratory E. Coli Total Coliform ND 5.00 ug/L EP200.8 C (<10) 12/14/10 12/16/10 KDC 12/15/10 AYC 0.357 0.100 mg/L SM20 4500NO3-F B (<10) Negative Negative 1 1 100mL SM20 9223B A 12/14/10 DLC 100mL SM20 9223E A 12/14/10 DLC Q O 0Z 3' o 1 o go P 0 w Noz = 0 W<• m Z a- w m oql au) -D r D Z -u 3-m o 7 () xPm • O)0 Z • Cn Q)rsa ox 0)—•(./1 r- 0 O (71 co r- 0 O -i (J1 0 r- 0 O U1 D / / co cv V 00 y'c Yor M UMW `$//OzZ mo<rmr-2—cz —oow - ^ a eƒ»»§E/ macm�s2�o0o0000» e mo, mm2mo m:000,OWO m7Eo-7=a&-a.<-cp R==-mooco E—E\i2t »\o< <r \72\/2kE ƒ®mE0= ,f (Da-F312-t-1. EIgE} E /�J. 07\$E/' oo# 3 °moo 0o R roc 0 CD j -, eL co m ; ®& (7, ® $ \\ }k / 0 / \