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Home My WebLink AboutGALATEA ESTATES BLK 8 LT 11Estates Block 8 Lot 11 #014-054-12 9 9 Al,,ine Drilling & Enterprises Well Log Permit Number: NSW141432 Date of Issue: 10-07-14 Parcel Identification Nva. Date Started: i01D-14 Date Completed; 1Q-10-14 Num 014054120D0 p is well Located at approved permit location? x Yes No Legal Description: Galatea Estates Black 8 Lof 11 Property 01mer Name & Address: l-lagmeler John C & Judith A DBA John Hagmeier Company 2204 Cleveland Ave # 201 Anchorage< Alaska 9,917 Borehole Data: Sail Type, Thickness 8,` Water Depth €t P �) Method of Drilling x air rotary ❑ cable tool Strata From To _ Casing type: steel Stick-up 0 2 Wall Thickness: _250 inches siltygravetfill - 2 6 Diameter: 6 inches Depth:110feet gravelly silt 6 1 finer ype: - silt Diameter: _ inches Depth; feet 13 28 __ Casing stickup above ground: 2 feet gravelly silt 28 41 Stolle wafer level (from otn ground level); /� feet sill uvet 41 63 'Dumping level: 105 feet after gravelly silt 63 89 = hours pumping 70} gP n sill 89 Recovery Rate: 20r gpm 94 gravelly silt 94 108 Well Intake Opening Type - water sand &gravel IDS IID x Open 3?nd ❑ O en Hoie p Screened Stant __fzet Stopped _„_ feet Grout Tvpe: bentonite cxranuies Volume: 2 hes, 31 r1 0-te� t�'r� F PUMP: Intake Depth feet Pum Size P - _ hp Brand T�a.•ne >1 1 v t _ tkell �t;sinr :r2:? F?}.cm ve yfetEcu? s 4'es � p I Method of Disinfection: chlorine tablets Z-+J22131�81YtS: Well Driller: Alpbie Drilling & Enterprives r''D ROx 110496 �� Anchorage AX 99511 10/05"2014 23:33 907-345-0202 ALPINE GRILLING PAGE 03/03 Development Services Department Building Safety Division On -Site Water At Wastewater Program e� av 4 4700 Elmore "toad P.O. Box 196650 Mark as 91ch Anchorage, AK 99507 8 A c T 1 Mayor www.nwni.ara/ans+ie (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW 141432 Date of Issue: 10.07-14 Parcel Identification Number: C 140541200 Legal Description PropaTr Owner Name & Address: Galatea Estates 61och a L-A 11 John tiagmeier Company 2204 Cleveland Ave 0 201 Anchorage, Alaska 00517 11 Pump Installation Date: �-/2312015 I Pump Intake Depth Below Top of Well Casing: 72 I Pump Manufacturer's Name: couids Pump Model: 10s1305 Pump Size 112 hp Pitless Adapter Burial Depth: 12 feet Pitless Adapter Manufacturer's Name: mhoeasan Pitless .Adapter Installer: Aarow Pump & well service, SLC Well Disinfected Upon Completion? Z Yes I No Method of Disin£eetion: Comments: Pump Installer Name: Aarow Pump & Wed Service, LLG P.Q. Box 110498 Anchorage. AK 69511-0498 feet Attention: The pump installer shall provide a pump installation lig to the DSD within 30 days of pump installation. 01 On-Site Water System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Sita Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Department Permit Number: OSP141432 Tax Code Number: 01405412000 Work Type: Well Initial Permit Effective Dates: October 07, 2014 to October 07, 2015 Design Engineer: Subdivision: GALATEA ESTATES Site LegalAddress: GALATEA ESTATES BLK 8 LT 11 G:2033 Owner/Address: HAGMEIER JOHN C & JUDITH A DBA JOHN HAGMEIER COMPANY 2204 CLEVELAND AVENUE #201 ANCHORAGE AK 995173011 Site Mailing Address: Lot Size in Sq Fi: 7200 Total BedroomS: 6 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 Chaptam 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: Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On-Site Water~& Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ~ ~., S ON-SITE SEWER/WELL PERMIT APPLICATION Pro pe ~y owner~~~~ ay p~~~ Mailing address ~~ /~ Site address ~ ~ ~ ~ Legal description (Township, Range & Sectien) Lot Size Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: ([~ all that apply) Absorption Field [] Initial [] Single Family (SF) (w/wo ADU) Septic Tank [] Upgrade [] Duplex (D) ~ Holding Tank [] Renewal [] Multiple Dwellings Privy [] (SF and/or D) Private Well [] UI iTTAL 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. "-- (b-~ture of property owner~r authorized agent) Perm it/Rush Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. Pemnit I ,BE0CK/LOTFFRAoT: BbK 8-/LT 11 / SUBDIVISION: GALATEA ESTATES I:AX CODE: 01405412000 STREET ADDRESS: , AK OWNER: HAGME ER JOHN C & JUD .TH A DBA JOHN H;~(JME ER COMPA PHONE: MAIL ADDRESS: 2204 OI~EVELAND AVENUE.~20') 'ANC}-I~)~A~E, AK ~95173011 CONTRACTOR BC Ezcavabng ASSESSMENTS [] Repair Exisbng Service [] Main D))eiE~eqsJon · ny ' [] CityTap [] Have Bee~ Lev ed ~ HydKa~t On]y D To Be Levied ,~ Maine, Tap~ To Prope~ Line Only ~ · ~mme~ts: . ~ · ~t . b~t ' ROW NO '"';'']' : ' ~ ,,, ' . ~ Ma n Tap & On Pmpe~ C · D Disconne~ ,, · · ~ ' - ~ ;," D R&R-ManTapOny ...... ~ner tStaff ~P~ ?' -' CONNECTSIZ~ 4n ISSUED ~SAP INSPECTION FEE $ 0.00 ~PAID 'D CASH · PERMIT FEE $ 72.00 D CHECK ¢ R,B~MBURSABbE DEPOSITS 103.00NsPEC~ED BY NUMBER TOTAL $ 175.Q0 ~ DATE / EMARKS · PERMITEE (Please Print) HAGMEI,ER JOHN C & JUDITH A,DBA JOHN HAGMBI~N~JMPANY MAIL ADDRESS 2204 CLEVELAND AVENUE #201 ANCHORAGE, AK 995173011 SIGNATU RE POST IN A CONSPICUOUS PLACE AT THE JOB SITE INSPECTOR COPY Parcel I. D. 014-054-12 RUSH Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Expiration Date: Galatea, Block 8, Lot 11 Location (site address) 6670/6672 O'Brien St. Anchorage, AK Current Property owner(s) John Hagmeier Homes LLC Day phone Mailing address 2204 Cleveland Ave. #201 Anchorage, AK 99517 Real Estate Agent 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) n Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 8 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer El WaiverNariance request for: Distance: Received by: Date: n 3 a6 i.S COSA to be released to the a gi er, unless otherwise requested by the engineer. COSA Fee $ 111. V9 Date of Payment L11.a.11T Receipt Number COSA # Q s C! S l l !Ol 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. "- In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA 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 thatthereare 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 Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for $ bedrooms System #2 Approved for bedrooms Disapproved Phone (907) 272-8218 Date 3/26/2015 Conditional approval for bedrooms, with the following stipulations: By: 4e, Original Certificate Date: T -o2 TheI16 nisili f horage. 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet °'- .e c If more than I septic system is on the lot: COSA Checklist # ± of +_ Structure served by this system I Certificate of On -Site Systems Approval Checklist Legal Description: Galatea, Block 8, Lot 11 Parcel IQ: 014-054-12 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log-(Y/N) Y Date completed 101.10/2914 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 110 ft. Cased to, 110 ft. Casing height (above ground) 18+ in. FROM WELL LOG Date of test 10/10/2014 Static water level 0 ft. Well production 20+ g.p.m. WATER SAMPLE RESULTS: AT INSPECTION New New fc. New. g.p.m. Coliform colonies/100 mL Nitrate 0.673 mg/L Arsenic ug/L Date of sample: 4115 Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material """'. Date installed Tanksize gal. Number of Compartments ` Cleanouts (Y/N) Foundation cleanout (YIN),— Depression over tank (Y/N) High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed _ Soil ratlrtg {g.p,dditz or felbdrm) System type. Length ft. Width ft. Gravel below pipe ft. Total depth fL , EI`f. 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 "Pump on" level at Datum _ Size in gallons Manhole/Access (YIN) in. °Pump off" level at in. High water alarm level at _ Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot NIA On adjacent lots 100+ Absorption field on lot N/A On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 1'004 - Animal containment areas 50+ Manurelanimal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO Building foundation Property line Water main Water service line Wells on adjacent lots ABSORPTION FIELD ON LOTTO: Property line Building foundation Water Service line Surface water Curtain drain Wells on adjacent lots F. COMMENTS' G. ENGINEER'S CERTIFICATION I certify that 1 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 Steven R. Pannone Date 3/26/2015 CASA canary sheet 2-6-15.doc Absorption field Surface water Water main Driveway, parkingtvehicle storage in. 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