HomeMy WebLinkAboutABBOTT LOOP MANOR BLK 4 LT 6Abbott Loop
Manor
Block 4
Lot 6
#014-181-43
ROM :Alpine Drilling
FAX NO. :907 345 0202 Feb.22 2012 02:29PM P1
Alpine Drilling & Enterprises
Well Log
Permit Number: #SW111165 Date of Issue: 12-5-11 Parcel Identification Number: 01418141-3000
Date Started: 12-6-11 Date Completed: 12-6-11 Is well located at approved permit location? x Yes No
Legal Description: Abott Loop Manor Block 4 Lot 6
Property Owner Name & Address: Merit Homes LLC
1920 W Dimond Blvd, Suite F
Anchoraae. Alaska 99515
Borehole Data:
Soil Type, Thickness & Water Strata
Depth (ft)
From To
Method of Drilling x air rotary ❑ cable tool
Casing type: steel
Stick-up
0
2
Wall Thickness: .250 inches
sill
gravelly salt
silty water sand & gravel
2
18
38
18
38
45
Diameter: 6 inches Depth: 101 feet
Liner Type:
Diameter: i inches Depth: _ feet
Casing stickup above ground: 2 feet.
silt
45
61
Static water level (from ground level): 23 feet
gravelly silt
61
65
Pumping level: -LOO feet after
silty gravel
water sand & gravel
65
97
97
101
2 hours pumping 20+ Spm
Recovery Rate: 20+ gpm
Method of Testing: air li
Well Intake Opening Type:
x Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
_
❑ Perforations Start _ feet Stopped _ feet
Grout Type: bentonite granules Volume. lbe
Denth: Start 0 feet Sto ?feet
Pump: Intake Depth _ feet
Pump size _ hp Brand Name
Well Disinfected Upon Completion? a Yes ❑ No
Method of Disinfection: chlorine tablets
Comments:
Well Driller: Alpine Drilling & Enterprises
PO Box II0496
Anchorage AK 99511
FROM :Alpine Drilling
FAX NO. :907 345 0202 Feb.22 2012 02:30PM P2
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
ppsa o`'o
4700 Elmore Road '
e
P.O. Box 196650 "
Mark ee9 ich Anchorage, AK 99507 s n c c v
Mayor www.muni.org/onsite
(907)343-7904
Pump Installation Log
Well Drilling Permit Number: SW 111166
Parcel Identification Number: 01418141.3000
Aboh Loop Manor Block 4 Lot 6
Pump
1.2-1a
Pump Intake Depth Below Top of Well Casing: 95 feet
Pump Manufacturer's Name: Grundfoe
Pump Model: 15 sq"7.180
Pump Size 314 hp
Pitless Adapter Burial Depth: 12 feet
Pltless Adapter Manufacturer's Name: Martinson
Pitless Adapter Installer. Rea Dog Masonary
Well Disinfected Upon Completion? 0 Yes ❑ No
Method of Disinfection: chlorine tablets
Comments:
Pump Installer Name: Aarow pump a well service
John Netherton
Date of Issue: 12-5.11
Property Owner Name &
Merlt Homea
1920 W Dimond Blvd. Suite F
Anchorage, Alaska 99515
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
SCS Ref.#
Client Name
Project Name/#
Client Sample 1D
Matrix
Sample Remarks:
1120154001
Anderson Engineering
Abbot Loop Manor B4 L6
Private Well Kitchen Sink Fauc
Drinking Water
Printed Date/Time
Collected Date/Time
Received Date/Time
Technical Director
01 /24/2012 11:26
01/12/2012 15:08
01/12/2012 15:30
Stephen C. Ede
Allowable Prep Analysis
Parameter Result LOQ Units Method ContainerlD Limits Date Date lnit
Metals by ICP/MS
Arsenic ND 5.00 ug/L EP200.8 C (40) 01/12/12 01/17/12 SCL
Waters Department
'Dotal Nitrate/Nitrite-N ND 0.100 mg/L SM204500NO3-F B (<10) OUt3/12 CMA
Microbiology Laboratory
E, Coll Negative I 1OOmL SM209223B A 01/12/12 DLC
Total Coliform Negative I IOOmL SM209223B A 01/12/12 DLC
On -Site Water System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP111165
Tax Code Number: 01418143000
Work Type: Well Initial
Permit Effective Dates: December 05, 2011 to December 04, 2012
Design Engineer: ANDERSON ENGINEERING
Subdivision: ABBOTT LOOP MANOR
Site Legal Address: ABBOTT LOOP MANOR BLK 4 LT 6 G:2233
Owner/Address: MERIT HOMES LLC
1920 W DIMOND BLVD STE F ANCHORAGE AK 995151471
Site Mailing Address: 2251 Rio Grande AVE, Anchorage Lot Size in Sq Ft: 9300
Total Bedrooms: 4
This permit is for the construction of:
N Disposal Field N Septic Tank N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: Date: 2- _
Issued By: Li r/vr, r�A" Date:
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
MayorDan Sullivan
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I. D. 014-41— 413
Property owner(s) /4U77'0r-J -,- LJG-n9 Dy Row ,%% Day phone
Mailing address ZZ -i3 Fo2J4 i&-cR._ 'jz►U'i" Ari cA4. AL gq,5n
Site address 144cs[ " b Z\JC7
Legal description (Sub'd., Block & Lot) A 139Orr LoOP A4.joA- Iwo,_ Ifo?- �p
Legal description (Township, Range & Section)
Lot Size qr 30D Sq. Ft. Number of Bedrooms ROVK' C4
THIS APPLICATION IS FOR:
(® all that apply)
Absorption Field ❑
Septic Tank
❑
Holding Tank
❑
Privy
❑
Private Well
Water Storage
❑
THIS APPLICATION IS AN:
Initial
M
Upgrade
❑
Renewal
❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permi Rush Fees:L'
Date of Payment:
Receipt Number: aab > �
Permit No. 0S 19 1111 �o J
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GABuilding\On Site\Forms\Client FormsTermit App_01 041 1.doc (Rev. 1/11)
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Municipality of Anchorage
Development Services Department
Building Safety Division k a
On -Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING (�
Parcell.D. 014-131-43 COSA# 05C1,2,1(l(1J6
Expiration Date: 13 Id -
1. GENERAL INFORMATION
Complete legal description Lot 6, Block 4, Abbott Loop Manor Subdivision
Location (site address) Anchorage. AK
Current Property owner(s) Merit Homes, LLC Day phone 334-9233
Mailing address 1920 W. Dimond Blvdl, Suite F Anchorage, AK 99515
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherivis'e requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: Four (4)
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well 0 Individual On-site ❑
Individual Water Storage ❑ Individual Holding Tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System ❑ 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 sample results. (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, 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 Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
5. DSD SIGNATURE
_Ae� Approved for bedrooms.
Disapproved.
Phone 522-7773
Date 3/6/2012
Conditional approval for bedrooms, with the following stipulations:
Attachments
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By. Original Certificate Date: 1
(Rev.I V05)
Municipality of Anchorage
• Development Services Department
Building Safety Division
_ On -Site Water & Wastewater Program s' `
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lot 6, Block 4, Abbott Loop Manor Subdivision Parcel ID: 014-181-43
A. WELL DATA
Well type Private If A. B, or C provide PWSID # _ Well Log (Y/N) Y
Date completed 12/6/2011 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y
Total depth 101 ft. Cased to 101 ft. Casing height (above ground) >18 in.
FROM WELL LOG AT INSPECTION
Date of test 12/6/2011
Static water level 23 ft.
ft.
Well production 20 g.p.m. 9 -
p.m -WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate N/D mg/L
Arsenic: N/D ugA Date of sample: 1/12/2012 Collected by: A. Harala
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material AWWU Sewer System Date installed
Tank size gal. Number of Compartments _ Cleanouts (Y/N)
Foundation cleanout (Y/N) Depression over tank (Y/N) _ High water alarm (Y/N)
Date of pumping Pumper
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ftz or ft2/bdrm) System type
Length ft. Width ft. Gravel below pipe ft.
Total depth ft. Eff. absorption area ft' 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
"Pump on" level at _ in. "Pump off' level at _ in.
Datum
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOTTO:
Septic tank/lift station on lot
N/A
Absorption field on lot
N/A
Public sewer main
»5'
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots N/A
On adjacent lots N/A
Public sewer manhole/cleanout >100'
Sewer /septic service line >25' Holding tank N/A
Animal containment areas >50' Manure/animal excretestorageareas >100'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation Property line Absorption field
Water main Water service line Surface water
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line Building foundation Water main
Water Service line Surface water Driveway, parking/vehicle storage
Curtain drain Wells on adjacent lots
F. COMMENTS: Lot is Served by AW WU Sewer System.
G. ENGINEER'S CERTIFICATION 9 C
..
1 certify that t have determined through field inspections and.: 4g�« ••s ••. . ��
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date. �ANlxf>iE Apo®sooe•;� B
Engineer's Printed Name Michael E. Anderson, P.E. ���J}'� ClE• tOsl •���2®
Date 3/6/2012
COSA Fee $ ciao' Waiver Fee $
Date of Payment 12 jf2 Date of Payment
Receipt Number sq6 B Tb Receipt Number
(Rev. 11/05)
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