HomeMy WebLinkAboutT13N R3W SEC 22 LT 3 OF 19T13N R3W
ec. 2 2
Lot 3 of 19
#006�313�07
Alaska state law requires that a copy of this well lot, be sent to the
Department of Natural Resources within 45 days: faxes are
acceptable- (AKstattites38.05.020,38.05.035�41.08.020,
46.15.020 and AK regulations I I AAC 93.140),
DNft/ Division of Mining, Land and Water.
i non
Within the City of Anchorage, it is required that a copy of the well log N
sent to the appropriate city office within 60 days and that another copy of
the well log lye sent to the welliproperty owner within 30 days -
Permit Number: OSPI41361
DMtP Of I�Rlle- A ....... � �17 �qnl A
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF MINING, LAND & WATER
WATER WELL LOG
Drilling Static& 28 �29 2014 Coniplctcd:W�_29 2014
citv/Borough: Subdivision: �]—�LOCK U)T
Property Owner Name & Address: FaisLena
Anchorage of 19
I
ite:2246 Candy Place 11552 Tulin Park Loop
r
Anchorage, AK 99516
Meridian ToNvnship__j3N Range 3W Section 22 'A Of 'A Of V4 Of 4
BOREHOLE DATA(from top of casing)Depth
Drilling method: (X) Air rotary, Cable tool, Other
Material: Type, Color & wetness From 1 To
. —
Wellusc:( )Publicsupply, (X)Domestic. other
stickup
0
2
Depth of hole: 118 ft, Casingstickup: 2 ft
Casing type: steel — Thickness: .250 inches
overburden
2
4
Casing diameter: 6 inches Casing depth: 118 ft
Liner type: Diameter: —inches Depth: ft
Static water (from top of casing): 55 ft on 08/29 /2014
silty clay & gravel
4
15
Pumping level & yield: feet after hours at gpm
Recovery rate: 30 gpm, Method of testing: airlift
glacial till
15
50
Development method: airlift Duration: I hour
blk clay & glacial till
so
78
Well intake opening type: (x ) Open end. Open hole, Other
Screened- Start: ft, Stopped ft
hard rock
78
80
Screen type: Slot/mesh size:
Perforated: Stan:— ft. Stopped: fi
silty glacial till
80
110
Start: 11, Stopped: ft
Note: ............. ....... .......................
clay layer
110
115
Grout type: bentonite Volume
Depft trom ground surface , to 20 ft
gravel w/ H20
115
118
Pump intake depth: ft
Pump size: lip, Brand name:
Was well disinfected upon completion? (X) Yes, ( )No
Method of disinfection:.Calciurn-Hypocftorite.(.Chlorine)...
Driller comments/ disclaimers: ....... ............ ......
.......................... .............. ................................................ ......
............................... ............... — ...................... ....... ..............
.................................. * ......... * .............. * ............................ . .
Well driller name: ......... �9q ... y
Company name: .... d 0y. P 0�i 1.J'flq'-.'
Mailing addrcss:...�P4.0..Ak.ula..Dr .................... ............................
city- Anchorage State: AK Zip 99516
Phone number: ( 907 345 0593 fax:345-4700
Drillers signature:
Alaska state law requires that a copy of this well lot, be sent to the
Department of Natural Resources within 45 days: faxes are
acceptable- (AKstattites38.05.020,38.05.035�41.08.020,
46.15.020 and AK regulations I I AAC 93.140),
DNft/ Division of Mining, Land and Water.
i non
Within the City of Anchorage, it is required that a copy of the well log N
sent to the appropriate city office within 60 days and that another copy of
the well log lye sent to the welliproperty owner within 30 days -
Permit Number: OSPI41361
DMtP Of I�Rlle- A ....... � �17 �qnl A
A- 4.
bevelopment Services bepartment
Building Safety bivision
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
mark Begich Anchorage, AK 99507
Mayor www-muni.org/orisit
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: Wt�* I q 1361 Date of Issue:At )7,),,Iq
Parcel Identification Number:
Legal Description
,�� qt. C-0irdy PL,
Pump Installation Date: I dl A / 14
Pump Intake Depth Below Top of Well Casing: / (20 feet
Pump Manufacturer's Name: 6*kd �0
Pump Model: /()5qE(,>
Pump Size 711-1 hp
Pitless Adapter Burial Depth: 10 feet
Pitless Adapter Manufacturer's Name: 8-10
Pitiless Adapter InstaHer: �4�7 0611 iy') J4 C_
Well Disinfected Upon Completion? F, Yes F No
Method of Disinfection:
Comments:
Pump Installier Name:
T�10) V� 4
Property Owner Name & Address:
L
ARE T
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
<
8401 T
The location of the stftjcture(s)as
shown on this record drawing UJ
(as-jbi cqormnpli TILJ21,A110C. c)
gJ
By:
Ala. -7-1?
LOT 3, CANDY SUBD. Z
<
EAST 165.60 20
Lot 20D \Wood'fence
C) cNi
Asphalt C)
0
CF)
_�Chaln link fence
7.8 CY)
24.0 24.0
LU
0 Lot 3 co
Or UJ (L
CY)
CNI 4 0 440 C) d)
C) C) a)
0
CD 4840 Wood fenc C)
0 0
Z 40 1 Story Frame Duplex 4.0
_39.3 C)
80.0 well z
SCALE: V= 30'
EAST 165.55
W1 12 Lot 30, Section 22, T1 3N, R3W, S.M., AK
OF
49th
00 % "-AICL
04 A F. Lee Koralbe ii�off,
L-3143 .- 6r�
45
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON. Plot Plan
0
AS -BUILT NO CORNERS SET THIS DATE
I hereby certify that I have perionned a Mortgagee's inspection
of the following described property,
LOT 3 OF NE4 SW4 NE4 SE4. SECTION 22,
T13N, R3W, SEWARD MERIDIAN, AK
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transrnission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 22nd ay of June .2015.
FRED WALATKA & ASSOCIATES
Engineers and Surveyors
(907-248-1666)
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: OSP141361
Tax Code Number: 00631307000
Work Type: Well None
Permit Effective Dates: August 27, 2014
Design Engineer:
Subdivision: T1 3N R3W SEC 22
to August 27, 2015
Site Legal Address: T13N R3W SEC 22 LT 3 OF 19 G:11537
Owner/Address: LENA FAIS
11552 TULIN PARK LOOP ANCHORAGE AK 995161404
Site Mailing Address: 2246 CANDY PL, DUPL 1, Anchorage
This permit is for the construction of:
Lot Size in Sq Ft: 16394
Total Bedrooms: 6
N Disposal Field N Septic Tank IN 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.
0*111111NOW
The following items shall be submitted for final approval to operate the well.
I.Asbuilt survey showing where the well was drilled.
2.Well log,
3.Well pump installation log,
4.Water quality test results.
gig
,Affi0XWkjftThe well driller shall confirm 100 foot separation to the sanitary sewer
manhole/cleanout located near the south end of Candy Place.
Received
Issued By
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
-1 A
Parcel I.D.
Property owner(s)
Mailing address _
Site address �L
Phone: 907-343-7904
Fax: 907-�43-7997
en
ON-SITESEWER"E PERMIT APPLICATION
ME
Legal description (Sub'd., Block & Lot)
*4
Day phoneqo4 164 -
Legal description (Township, Range & Section) '3 Of e�JE 5�w 10F 1614 , 'C—C C) OAJ 2-2—
\I,j
�o 5:o 3 q. Ft. e
Lot Size mbd4rof �Brot�ms
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(10 all that apply) Single Family (SF) El
Absorption Field El Initial El (w/wo ADU)
Septic Tank El Upgrade El Duplex (D). All/
Holding Tank Renewal El Multiple Dwellings El
Privy (SF and/or D)
Private Well
El
Water Storage SuAmIVAL
AU6 2
THIS APPLICATION INCLUDES A VARIANCE /WAIVER MUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this'"is"fin' accordance with
applicable Municipal Codes
(Signature orproperty oWner or authorized agent)
I
Permit/Rush Fees: Wp_vs
DateofPayment:_ �H,"N ( 4�
Receipt Number:
Permit No. 05? 1
Permit App_9-1-12.doe
Waiver Fees:
-1 Date of Payment:
Receipt Number:
Waiver No.
I C— 5� �V If cl--
Lot 20D
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00
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ori -,'haV of, dcm� as shown,, t�,
,:;�o �pprw�cclplawandapecjfz
Juails 'izq� 'w oc changed, modified
ralteredwi-r,! Arst obtaining a vati(
-ro�� LOT 3, CANDY SUED.
EAST 165.60
W
V
(/
Lot 3
(1 6,384±s
C)
8.7 Z4.0
CY)
C:�z J
Fin=203.0
C). 1.;, 1, � I - .. I � I — � 7,
Fin=203.0
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4.0 1 Story Frame Ouplex 4.0
0
- 1�1
Top fdn= 203.7
0
go C;
6
1�01—
80.0 � M
Ex=202.51
z
PIP
HOOHN11-
(2-
L)
r&
EAST 16155
"/2 Lot 30, section 22, T13N, R3W, S.M., As UBMiTTAL
0 Staking prior to construction AUG 014 2014
-/-r ZeAr)-- TOMMY CORNELL
OF &
A, PROPOSED CONSTRUCTION
9th .-.7,
11110 1 hereby certify that I have surveyed the following described
4 **- .*Ill'
.... 00 Property: LOT 3 OF NE4 SW4 NE4 SE4, SECTION 22,
00 Tl 3N. R3W. SEWARD MERIDIAN. AK
Anchorage Recording District, Alaska, and that the
F r Walatka improvements situated thereon are within the property lines and
AW do not ovedap or encroach on the property lying adjacent
3255 S -*P thereto, that no improvements on property lying adjacent thereto
SCALE: V= 30' encroach on the premises in question and that there are no
-1)?o roadways, transmission lines or other visible easements on
said property except as indicated hereon.
EASEMENTS OF RECORD, OTHER THAN Dated at Anchorage, Alaska
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON.
IQ
This. list day of August 2014.
FRED WALATKA & ASSOCIATES
(907-248-1666) Engineers and Surveyors
Municipality of Anc
On -Site Water and Wastewater
(907) 343-7904
'RUSH!
in 13 Z015
Certificate of On -Site Systems
Parcel I.D. 006-313-07
1. GENERAL INFORMATION
Complete legal description
Expiration
T1 3N R3W Section 22 Lot 3 of 19
Location (site address) 2246 Candy Place Anchorage, AK
Current Property owner(�% Fais Lena
s) Day phone
Mailing address 11552 Tulin Park Loop Anchorage, AK 99516
Real Estate Agent Day phone —
2. TYPE OF DWELLING:
[j Single Family (w1wo ADU)
Fx-1 Duplex
F] Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 6
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Individual 0
Individual Water Storage El Holding Tank E]
Community Class _Well 1-1 Community 1-1
Public Water System E] Public Sewer F-1
Waiver/Variance request
Received by:
COSA to be released to the engineer,
othervAse requested by the engineer.
COSAFee $ (,q�o g/A =
Date of Payment 64,,
Receipt Number
COSA # 0512,1151 206�
Date:
Waiver Fee $
Date of Payment
Receipt Number.
Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my sea] 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.
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2 Approved for bedrooms
Disapproved
Phone 522-7773
'Date 7112 Qj�._
OF A4 V4#
H . ..70,
0
V0* MI A9 ERSON jo
AV
E-4381
Conditional approval for _ bedrooms, with the following
By: (9, x///,--� Original Certificate Date:
gnic�l 4yrCO/f
The A orage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based oflly
K'rag
upon the representa on, ,v,, in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage Is not responsible foreffors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA bl.esh..Lf '. !� C
If more than I septic system is on the lot:
COSA Checklist # —of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: T1 3N R3W Section 22 Lot 3 of 19
A. WELL DATA
Well type Private If A, B, or C provide PWSID #
Date completed 8/29/14 Sanitary sea[ (Y/N) Y
Total depth 118 ft. Cased to 118
FROM WELL LOG
Date of test 8/29/14
Static water level 55
Well production 30 9 -P.M.
WATER SAMPLE RESULTS:
Coliform 0 olonies/100 mL Nitrate ND
--i—c mg/L
Arsenic 34.8 ug/L Dateofsample: 7/1/15
B. SEPTIC/HOLDING TANK DATA - AWWU Sewer System
Tank Type/Material
Tank size — gal. Number of Compartments_
Foundation cleanout (Y/N) — Depression over tank (YIN)
Date of pumping Pumper
Parcel ID: 006-313-07
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) > 18 in.
AT INSPECTION
ft.
9.P.M.
Collected by: And. Engineering
Date installed
Cleanouts (Y/N)
High water alarm (Y/N)
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ft' or ebdrm) System type
Length ft. Width ft. Gravel below pipe _ ft.
Total depth _ ft. Eff. absorption area Monitoring tube _ Depression over field
Date of adequacy test Results (Pass/Fall) 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.) (YIN & type) If yes, give date -
D. LIFT STATION
Date installed
"Pump on" level at
Datum
— Size in gallons Manhole/Access (Y/N)
in. "Pump off" level at in. High water alarm level at _ in.
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
KIA
Septic tankllift station on lot On adjacent lots
Absorption field on lot NA On adjacent lots >100,
Public sewer main >75' Public sewer manhole/cleanout >100,
Sewer /septic service line >25' Holding tank >75'
Animal containment areas >50' Manure/animal excrete storage areas >100'
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
_ Property line _
Absorption field
Water main
Water service line
Surface water
Wells on adjacent lots
..
. ..... .............
MICHAEL E.'ANDERSON CL *1
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 AWWU Sewer System.
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.
,W
Engineers Printed Name.Michael E. Anderson, P. E.
so
so -.60"s . ... ...
04 =. 4
Date 7/12/2015
..
. ..... .............
MICHAEL E.'ANDERSON CL *1
CE - 438 1
COSA brmn sheet-10-IG-12.doG
Municipality of Anchorage
Community Development Department
Development Services Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Arsenic Advisory
Certificate of On -Site Systems Approval # 151356
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
3 of 19 of T13N R3W Section 22 Subdivision. This inspection revealed an
arsenic concentration of 34.8 micrograms per liter (ug/L) for the property's
well water sample. The Environmental Protection Agency (EPA) has
established a maximum contaminant level (MCL) of 10.0 ug/L for public
drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
information on arsenic is available from the On -Site Water and Wastewater
Program website (www.muni.org/onsite) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.