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Home My WebLink AboutMCMAHON #2 BLK 6 LT 8J u n 04 '21 12: 5 6. P Arioha! "Nell <N PLM, i;) SP -1 9072430742 n.1 MUNICIr"ALITY OF ANCHORAGE Development Services Department m : on -Sits Wa-'er & kqaptewater Section one907-343-7904 Fax. 907-343-7997 Pump Installation Log Well Driffing Permit Number.- Date of Issue: Ic- - 3 Legal Description M C III � 11� 0, k 0 11) Pump ills Block i or Property Owner Name & tiddress: I Pump Intake Depth Below Top of Well Casing: fit PIMP Manufacturer's Narne: Pump Model; Pump 'Sae: Jt1p Pitless Adapter Burial Depth: tier rt PitleSS Adapter N131lufacturer's Name: 11 Pidem Adapter Installer, 1� W811 bislafected Upon ComVktjrjn? ZYeS 1 NO Method of Disinfection, Ii), 4 conlruents-, Pump Installer N1- ANCHONAGE WELL PUNIP SERVICL Company: 7540 Kirs Street Anchorage, AK 995 Jkwliag Address: PH, (SC7) 243-0-140 City: "Ontilm- ThO PanT insta [ter sha.] prwt-de a pip jijstal-,atjor, 10, g" 0On-,';Itewih'n2Ologs ofpump ;nztailar.ion. QGR!"-'ER ANCHORAGE AREA Bo'r UGH Department ~3E0n~irs~2~ntal Quality Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME //~/ c'//-*¢2/¢-'-/~:~ ~/~'~-~ MAILING ADDRESS ~r~ ~~ ~'~ ~ PHONE LOCATION //v//~/J~/Y-~'/~- /~'~'~//~-/'- LEGAL DESCRIPTION SEPTIC TANK: DISTANCE .-~'~-~-:~--¢~- /~_~- NUMBER OF FROM WEL~/'~/~ MANUFACTURER ~-~/~¢ ' MATERIAL~'/~--~-~ COMPARTMENTS // INSIDE LENGTH --' INSIDE WIDTH -- LIQUID DEPTH ~.LIQUID CAPACITY -/'/"~-~'/~-~ GALLONS. SEEPAGE PIT: NUMBER OF PITS /. DIAMETER OR WIDTH/~,. ~LENGTH//~, /DEPTH -~ / LINING MATERIAI_/¢'//4/~~' CRIB SIZE: DIAMETER /~/ DEPTH ~/~ / ¢ ~ - DISTANCE FROM: WELL 'N~~.~~ / T O T AL EFFE C T IVE BUILDING FOUNDATIO AREST LOT LINE'~-~ './~?" ~ ~" ABSORPTION AREA (WALL AREA) SQ, FT, ADDITIONAL ABSORPTION WELL: TYPE BUI LDI NG '*/f~'cz~-/~, FOUNDATION C. E S S p O O L/?~//~'-/~'" CONSTRUCTION NEAREST /'~,¢/Z~?/¢ NEAREST LOT LINE/Z) ~ SEWER LINE '~'5~ OTHER SOURCES APPROVED DISAPPROVED REMARKS DEPTH SEPTIC TANK DISTANCE FROM: SEEPAGE SYSTEM /~'~ ~¢ DISTANCES: INSTALLED BY: /~/z%~'- PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. LO-031 DIAGRAM OF SYSTEM APPROVED G.A.A.B. GREATEr ANCHORAGE ArEa Borough DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA ggS03 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT PERMIT NO. MAILing ADDRESS '"'~'/~ ~/'~/~ PHONE NAME OF APPLICANT INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD , OTHER T/O BE INStalLED BY FINANCED THROUGH // JJ/~'o ~_~ ~/J~-~ ~'~/~j~-~'~.~*'~? ~'~/~ ~)~:;~"~ SOIL TEST RESULTS ~~/~ ./ / ' ~~NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TE~T FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY Will BE SUBJECT TO PROSECUTION. MINIMUM DISTANCEB, REQUIREMENTS FOUNDATION TO SEPTIC TANK ~/// FOUNDATION TO SEEPAGE PIT ~ / ~ SEPTIC TANK TO SEEPage Pit WaLL ~ ~ SEPTIC TANK ~/ SEEPAGE PIT ~ / DRAIN field TO NEAREST LOT LINE, DRain FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD , SEEPAGE PIT TO RIVER, LAKE, STREAM. SEEPAge Pit · ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FI ELD~.~/~ CAST IRON INTO AND OUT OF SEPTIC TANK and INTO CRIB CROSSING gAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DIAGRAM OF B¥$TE~ i CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER aNCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DATE APPLICANT'S ~IGNATURE , D'APPOLONIA- BROOKER- LAMBE ~ M~'(~LELLAN D CONSULTING ENGINEERS Certified .Well .......... , ...... ~ ·. · ~~4h.~ ~'~' ~; ~ ~ ~ Date completed... ;~:Z~.Z .Z~: ...... . ....... ~.~.~/.~ff~a, ~ Depth of well..-, i : .. ~:~. ~e .. ~ ~ff~.-.~-'~:~;t~ , · .~.. ::,.q?- .,~:??.::.-~ ~ .....'*-""'~ ~1~~ ~' .., Dis~ce ~o watez ....... ~, ......... ~... o~ ....... e.e~ ....... ~z~o~ ~ ~o~. ~-~ ~t~ cs ?~.~.~ , I certi~y t~e above trt~e and, correct. .....6 ~-.~..'FT)..-... :... ~¢'*~'~'1 Driller MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION WILSON WELL DRILLING ANCHORAGE, ALASKA We advise you to attac~ this certificate to your dee(~l~.t~..~V ASSOCIATED OFFICES IN ANCHORAGE, ALASKA--HOUSTON, TEXAS EDMONTON, ALBERTA-- PITTSBURGH, PA.--BOSTON, MASS. MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 017-361-30 1. Certificate of On -Site Systems Approval Expiration Date:; 7" Zd 2-0 GENERAL INFORMATION Complete legal description McMahon #2 B6 L8 Location (site address) 12900 NOrak PI. Current property owners) James & Amanda Steward Day phone 775-2022 Mailing address 12900 Norak PI., Anchorage, AK 910516 Real estate agent Kevin Cross 2. TYPE OF DWELLING: x❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day 529-2289 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic 0 Water Storage ❑ Holding Tank j ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer i r. ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �'b " �� Waiver Fee $ i; Date of Payment Date Date of Payment f Receipt Numberr� Receipt Number COSA # r.J cS C 26 1 a5'T 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Eklutna Engineering, LLC. Phone 355-9820 Address 19162 Mountain Rd., Chugiak, AK 99567 Engineer's Printed Name Curtis Townsend Date 6/11/2020 6. DSD SIGNATURE _ System #1 Approved for 6 bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms '••.* �p t .• . �•T • • •nd•• •.. rr zoz� ��FC�slDate No.0 1196t •.��`sv� bedrooms, with the following stipulations: r�rrrrm y: Original Certificate Date:. —/7-2 Z 0 The Municipality of Anchorage 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. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: McMahon #2 B6 L8 Parcel ID: 017-361-30 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system _ A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 3.5 gpm Date drilled 10/7/1974 Water storage tank volumen/a gallons Total depth 99' 11" ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to > 50 ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate 10.7 mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic N/D ug1L ❑ Arsenic less than MRL (ND) Casing height (above ground) 13 in. Collected by Brandon's On -Site Services, LLC Date of flow test for COSA 5/28.2020 Date of Sample 5/28.2020 Static water level at beginning of test 86.6 ft. Comments well was investigated via camera June 2020. No damage to casing found to a depth of 50' B. TANK DATA Age of tank(s) 4 years Tank type/material septic Steel Measured operating fluid level in septic tank OR Standpipes/foundation cleanout per record drawing Date of pumping 12/6/2019 ,� D. ABSORPTION FIELD DATA Which system tested (date installed) 9'14'2016 [10-1ALLstandpipes present per record drawing Total measured depth from grade 10.9 ft (max) Measured depth to pipe invert from grade 3 ft (min) ❑ N/A — pressurized field ®❑ Monitor tubes go to bottom of effective. If not, state depth into effective OF Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comm ents/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station year / � Lift station material Comments: Adequacy test date 5'28'2020 Results Q Pass For 5 bedrooms Fluid depth prior to test 0 in Water added 753.7 gal New depth 0 in Elapsed time 0 min Final fluid depth 0 in Absorption rate 753.7 gpd Any rejuvenation treatment (past 12 months) n/a If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0✓ Yes Community Sewer Manhole/Cleanout > 100' Q✓ Yes if No ft 7 Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' 0✓ Yes if No ft Absorption Field on Lot > 100' M✓ Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' 0✓ Yes if No ft Water Main > 10' Animal Containment > 50' Yes if No ft F-71 Yes if No ft Yes if No ft Water Service Line > 10'✓� Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' M✓ Yes if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0✓ Yes if No ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: ✓� Absorption Field > 5' if No Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Main > 10' ✓0 Yes if No ft Community Wells > 200'✓Q Yes if No ft Water Service Line > 10'✓� Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 2 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓� Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' F71 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / 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. ENGiNEF- W COSA Checklist yellow sheet" ° ° •' • •' • �6�r.. l .T ..send ...... �•. Date2G��Q ry �ecsl..No.0 Nitrate Advisory Certificate of On -Site Systems Approval # OSC201257 Subdivision: McMahon #2, Block: 6, Lot: 8 A water sample revealed a nitrate concentration of 10.9 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/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. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. gg k� �� Ma�lmg A�cildress P �O Bbx 196650;* Anchorage, Alaska 99519 6650 *www mium or From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. they recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address P O Box 196650 *SAnchorage, AlasCa 99519 6650 *wwWNW w muni org Anchorage Well & Pump Service, Inc. 330 East 76th Avenue Anchorage, Alaska 99518 (907)243-0740 AMANDA STEWART 12900 NORAK PLACE ANCHORAGE, AK 99516 USA Invoice Invoice #: 20204907 AMANDA STEWART 12900 NORAK PLACE ANCHORAGE, AK 99516 USA SALESPERSON YOUR NO. SHIP VIA COL PPD SHIP DATE TERMS DATE PG. MARC S. PATTERSON 30615 Net 10 6/12/2020 1 TY. ITEM NO. DESCRIPTION PRICE DISC % EXTENDED TX. PRICE 1 Service Call CAMERA WELL 1 Field Service 06/11/2020 - MOB TO JOB SITE CHECK $99.00 $99.00 SYSTEM - REMOVE SANITARY WELL SEAL AND CAMERA WATER WELL - FOUND NO DAMAGE TO WELL CASING UP TO 50 FEET FROM TOC - WELL CASING EXTENDS PAST 50 FEET - REINSTALL SANITARY WELL SEAL AND DEMOB FROM JOB SITE. 0.5 ST15 Service Tech: Marc Patterson $99.00 $49.50 0.5 ST5 Service Tech: Tyler Ridgway $99.00 $49.50 1 CAMERA WELL CAMERA $400.00 $400.00 SALE AMT. $598.00FREIGHT We appreciate your business. $0.00 SALES TAX $0.00 TOTAL AMT. $598.00 PAID TODAY $0.00 BALANCE DUE $598.00