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Home My WebLink AboutSUNSET HILLS BLK B LT 22Sunset Hills Block B Lot 22 #018-201-59 05/31/2015 22:04 907-345-0202 ALPINE DRILLING PAGE 01/01 Legal Description Property Owner Name & Address: Block B, Lot 22 Sunset Hills Six M Ceder Homasf Matt Matthews 2804 W. Northern UgMs Blvd, Sude 8 Anchorage, AK 99517 Installation Date: 9 I&X)16 Pump Cntaise Depth llelow Top ofWell Caring: 122 Pump manufacturees Name: Goods Pump Model: 108607422C pump Size 314 by PidessAdapter BarialDeptht NIA feet Pifiess Adapter Manufrctnrer's Name: NIA pitiless Adapter Installer: NIA Well Visinfected Upon Completion? tZ Yes ❑ No Method of Dislafecamt: Comments: PMP .instalterNwne: Aerow Rump & Well Service, LLC P.O. Box 110496 Anchorage, AK 99611-0496 Celt .4ttention: The pump installer shall provi4 a puanp installation tog to the DSD within 30 days of pantap imtallatiou. Lv:/ bevelopment Services Department Building Safety Division yf♦'�r3fte Yr stet R 7Y a3lewater Qr��ram4700 !~furore RoodP.O. *AZ Sox 196650 MarkSe91' Anchorage, AK 99507 UO)w A-WWOni.o r Y_e. (907)343-7984 Plump Installation Log Well Drilling Pertufit Number; SW (j04314 Date of Issue: 2L2 2000 parcel Identification Number. 018-201-59 Legal Description Property Owner Name & Address: Block B, Lot 22 Sunset Hills Six M Ceder Homasf Matt Matthews 2804 W. Northern UgMs Blvd, Sude 8 Anchorage, AK 99517 Installation Date: 9 I&X)16 Pump Cntaise Depth llelow Top ofWell Caring: 122 Pump manufacturees Name: Goods Pump Model: 108607422C pump Size 314 by PidessAdapter BarialDeptht NIA feet Pifiess Adapter Manufrctnrer's Name: NIA pitiless Adapter Installer: NIA Well Visinfected Upon Completion? tZ Yes ❑ No Method of Dislafecamt: Comments: PMP .instalterNwne: Aerow Rump & Well Service, LLC P.O. Box 110496 Anchorage, AK 99611-0496 Celt .4ttention: The pump installer shall provi4 a puanp installation tog to the DSD within 30 days of pantap imtallatiou. Lv:/ HEFTY DRILLING 3540 AKULA DRIVE ANCHORAGE, ALASKA 99516 STATE OF ALASKA ~ DEPARTMENT OF NATURAL RESOURCES MINING, LAND, WATER tlYDROLOGIC SURVEY (907) 345-0593 ICity/Borough: L Subdivision/USS: ....... :':::.'--":'": WATER WELL LOG Drilling Started: ?__///o / 0 !, Completed: ~ / /~. / 0 t Block Lot Pmp~ny Owner N,~ & Address: Range Section ... ~of .NAD: 27 OR 83 Elcvaliou: BOREHOLE DATA: (from ground surface) Depth Material: Type, Color & wemess I Fl~m I Drilling method: O Air rotary, O Cable tool, Other Well use: I-I Public supply, [] Domestic, 0 Other Depth of hole: /,..~] IL Casing stickup: ft Casing type: '~-/'~,,t l Thick~ess -~',,~ & inches Casing diameter. ~, inches Casing depth /,,~/ fl Liner type: Diameter. inches Depth: fl Staticwater(fromtopofeasing): ~ flon ~' Pumping level ff,: yield: -_' ~ :' feet after hours at Recovery rate: .--~" gpm, Method of testing: Development method: Duration: Well intake opening type: )~f,,O. pen end, D Open hole D Screened; Start: / ft., Stopped fl Screen type: Slot/mesh size D Perforated;Start: tL Stopped fl Start: IL Stopped fl Note: Grout type: ,~= ~'~ *.~-,,"1~ Volume Depth; froTM Pump intake depth: Pump size IL to fl fl bp, Brand name: ................ Was well disinfected upon completion? Method of disinfection: Driller comments/disclaimers: n Yes, [] No Well Driller Name: Company Name: HEFTY DRILLING Mailing Address:, 3540 AKULA DRIVE City:~State: ALASKA Phone Zip: 99516 Drillers ssithin 45 da.~ ~. Fa,~¢,s arc acccolabl¢. (AK statutes 38.05.020, 38.0~.03~, 41.08.020, 46.15.020 ~d ~ ~gulaions I I ~C 93.140). DEPARTME~ OF NATU~L RESOURC~ Mining, ~nd & Water Hydrologic Su~ey 5~ W 7th Ave~ Suite ~A Anchorage, AK ~1~577 Telephone {907) 269~9 and FAX (907) 562-1384 Within the City of Anchorage, it is required that a copy of the well log be sent to the appropriate city office within 60 days and that another copy of the well log be sent to the well/property owner within 30 days. Permit Number: Date of Issue: I / Parcel Identification Number: Is well located at approved permit location? D Yes or 13 No · Municipality of Anchorage Geo~e P. Wuerch, Mayo~~r Bttildmg Safc~' Dixqsion P.O. Box 196650 · 4700 S. Bragaw Strcct Anchorage, Alaska 90519-6650 * {007) 32t3.8301 h t tp://wwv.'.cl.anchorag¢.ak.us 7/13/2001 Public ~'orks RJ Stover PO Box 220162 Anchorage AK 99522 Subject: On-Site Water and/or Wastewater Permit. Permit Number: SW000314 Legal Description: Sunset Hills Blk BLt 22 Dear RJ Stover: An On-Site Water/W'astewater Permit, number SW000314, issued by this office for a single-family system, will expire on August 22, 2001. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as-built inspection report must be sent to this office for review, approval and documentation. This as-built inspection report must be signed by the licensed Professional Engineer who inspected the installation ofthe system. As-built inspection repons are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit may be issued free of charge for a second year if the application for the renewal is received on or before the date of expiration ofthe original permit. When applying for a new permit, the fees are: $320.00 for a wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-7904. Jar~es Cross, PE Manager On-Site Water and Wastewater Program enc: Copy of permit MUNICIPALIT~ OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P,O. Box 196650, Anchorage, AK 9951g-6650 (907) 343-4744 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: Aug 22, 2000 Expiration Date: Aug 22, 2001 Permit Number: SW000314 Legal Description: Sunset Hills, Lot 22, Block B Design Engineer: 0000 None Required Owner Name: P,,J Stover Owner Address: PO Box 220162 Anchorage, AK 99522- Parcel ID: 018-201-59 Site Address: 14031 Sunview Dr. Lot Size: 15600 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under consb'uction 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: Date: ~ 2~"~ ~'~ Date: ~ "2 % -'~)~ MUNICIPALITY F Development Services Department = On -Site Water & Wastewater Section Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax. 907-343-7997 Parcel I.D. 018 201 59 Expiration Date: 1J/ a/0-1 1. GENERAL INFORMATION Complete legal description SUNSET HILLS BLOCK B LOT 22 Location (site address) 14035 SUNVIEW DRIVE Current property owner(s) HUGHES, BLAI R Mailing address Real estate agent 2. TYPE OF DWELLING: ❑ Single Family (w/ADU) ❑ Duplex Fx-1 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ED Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer D Waiver request for: NONE Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment Tf z 9,0, Date of Payment Receipt Number 0-4 3 5g 6 Receipt Number COSA # 0SC a.11 9H 9 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 8/1/21 OF At- 49 TH •.* I 6. DSD SIGNATURE�••.•••• ••••• r .,. •r�, r� System #1 Approved for L( bedrooms /r ' ' ' ' ' ' ' ' / CHARLES G BALZARIKI e System #2 Approved for bedrooms r�F��. . CE -13854 Disapproved ill; PR ....�� Conditional approval for bedrooms, with the following stipulations: �.� WAST'EvVATER ?.; 75, PROGFAM 01)))))111 By: Gi% Original Certificate Date: g /q 2 The Municipality of Anc age 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 X Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: 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) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: STEEL Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) COSA Checklist yellow sheet 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’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ 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’ Yes if No ft Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft F.ENGINEER’S 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. 1'"itrate Advisory Certificate of On -Site Systems Approval # OSC211448 Subdivision: Sunset Hills, Block: B, Lot: 22 A water sample revealed a nitrate concentration of 7.14 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. Since nitrates are known to slowly increase, we recommend you monitor the water quality. 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. Mailing address P"O Bo�196650 Anchorage; Alaska 99519 6650 www muni org � DATE SCHEDULED 12/31/2015 TIME 12:00 am INSPECTOR ('�,�5 p. � i SUBDIVISION SUNSET HILLS BLOCK/LOT/TRA—CT'—BLSK B / LT 221 INDICATE NORTH i i � +4 � Mo N _ (P � T n SIZE MAIN: TYPE MAIN: DEPTH AT MAIN: AT PROP. LINE: 1 CONNECT LOCATION: 15 ! p L COMMENTS: INSEPECTE,QB� DATE: 04 ,6�