The URL can be used to link to this page

Home My WebLink AboutFIRE LAKE LT 4 TR KFire Lake Tract Lot 4 K #051-332-26 Certified Drilling Log &LIVAlUccWATER 1111ELLS P.O. Bax 67026.9, Cbugiak, AK 99567 888-2758 OWNER OF LAND: Wayne & Darlene Dunn ADDRESS: 18515 Fish Hatchery DR. Eagle River LEGAL DESCRIPTION Fire Lake Lot 4 Tract K DATE: 9/10/13 PERMIT NUMBER. 131236 DATE OF ISSUE: 8/6/13 TAX IDENTIFICATION NUMBER 05133226000 Is well located at approved permit location: ® Yes ❑ No Method of Drilling: Nairrotary El cable tool Depth of Well: 400ft Casing Type: steel Wall thickness ,025 inches Diameter: 6 inches, depth 44ft feet Liner type none Bedrock gray Static Water Level: flowing feet Recovery Rate 20 ❑ gpm N gph Method of Testing air 135 Well Intake Opening Type: ❑ open end N open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite grout Volume: Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: N yes ❑ no Method of Disinfection: - Chlorine 50 ppm Comments: Bore Hole Data Depth 0 2 - Casing stickup 2 90 Bedrock gray 90 110 Bedrock hard green 110 135 Bedrock gray 135 195 - Bedrock gray quartz through out 195 227 Bedrock dark gray 227 241 Bedrock gray 241 370 Bedrock hard green 375 378 Bedrock gray quartz seams wet 378 400 Bedrock gray Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. BILL &, COLEOccodtr ,�► IILLIVAN WATER WELLS P.O. Box 670269, Chugiak, AK 99567 688-2759 www.suilivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSPI31236 Date of Issue 8-6-13 Parcel Identification Number: 05133226000 Legal Description Fire Lake Lot 4 Tr K Pump Installation Date: 5-5-15 Pump Intake Depth Below Top of Well Casing: 385 Pump manufacturer's Name: Goulds Pump Model: SSB10412CL Pump Size: 1 Pitless Adapter Burial Depth: 30 Pitless Adapter Installer: Sullivan Water Wells Disinfected Upon Completion? ® yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson B10X Property Owner Name & Address Wayne & Darlene Dunn 18515 Fish Hatchery Road, Eagle River, AK 99577 feet hp feet Pump Installers Name: Terry Worrell & Cole Sullivan — Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Un -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: OSP131236 Tax Code Number: 05133226000 Nork Type: Well Permit Effective Dates: August 06, 2013 to August 06, 2014 Design Engineer: Subdivision: FIRE LAKE Site Legal Address: FIRE LAKE LT 4 TR K G:0554 Dwner/Address: DUNN WAYNE E & DARLENE P 18515 FISH HATCHERY ROAD EAGLE RIVER AK 995779208 Site Mailing Address: 19088 FISH HATCHERY RD, Eagle River Lot Size in Sq Ft: Total Bedrooms: This permit is for the construction of: 108900 3 N Disposal Field N Septic Tank N Holding Tank N Privy Y Private Well N Water Storage 411 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. 2eceivi ssued w1ik `—u��iUGn %li0.�t✓ l�el�5 5�afeS I�R/- 7%le or r nal wa�fr source aaa not a SII r i> Ala oitlY 5' Cep /Uo (,()el( Deco�+n,i5sron�%y 1� repur'rcp, I MUNICIPALITY OF ANCHORAGE nt-wi Community Development Department Phone: 907-343-7904 Development SerAces Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. Os'/ -332 -2 w1-09 ``96 �0LLtr Property owner(s) AI AI W�r,c,� `/__ 04'-1-4- A✓ -f Day phon Mailing address l��/ Fs J7tafic� arch 2� r i e I7+ir@� Site address l qO gI? Lag le 121yep Legal description (Sub'd., Block & Lot) Loft /� %� K /Iva / Legal description (Township, Range & Section) if 4) S Lot Size 01?'jW1 Sq. Ft. Number of Bedrooms 7 APPLICATION IS FOR: (® all that apply} Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well %b ck 1+�Date of Payment: Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initialmil Single Family (SF) 9 Waiver Fees: _ (w/wo ADU) %b ck 1+�Date of Payment: Upgrade ❑ Duplex (D) ❑ Renewal ❑ Multiple Dwellings ❑ (SF and/or D) 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. oq"t' -- oT property owner or autnorizea agent) Permit/Rush Fees: Waiver Fees: _ Date of Payment: 1Xa1. %b ck 1+�Date of Payment: Receipt Number: 1 S, 4 1 3 Receipt Number: Permit No. 0S1F 13 19340 Waiver No. Permit App_9-1-12.doc .G - Low 'Cia i•csr �- F� ----------------- LAY .sem _ —-� 3 45R- l i do v G-� A•L • �G T�/.iiL. '1- evc aVe -'� � 1e f� Pj ! s sues Tlr .T �.aa LS • V �%� � � 1.k� 2'IT rr. 5`Y r -r. (�-h:0 Wt4AA &Pip. 31aa' 1—v 4 T¢p.v v- �J a Na1� ; a} rh - Qua�iTy 'rfy�prq�� lawE c�,eRiy) vaoCq. pr �owher� f vJf.-u. �d we 1l7a 6 o/ccoH^- v1 re, per T/ t �� CO�� 0 S & S ENGI JEERING SR B 196X EAGLE RIVER, AK 99577 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROIt:CltON DE ITMENT OF HEALTH AND HUMAN SER\ ZS Environmental Health Division t986 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 o.-S TE SEWAGE D,SPOSAL SYSTEM A.D/O. WELL .SPECT,fL Eg rE ~m~ DISTANCES ~o~ ~ ~~ ~ SEPTIC ABSORPTION Address TANK FIELD WELL ~, ~, ~ ~ o~ ~~ ~ WELL I-- LEGAL DESCRIPTION LOT LINE LOt ~ ~ SubOlVlS'~ ~ ~ FOUNDATION ~ h ~ [/~ ~ , driveway, water bodies, etc.) ~[~ ) TANKS l()J~ ) 2~ )~,~ 0 N ~ SEPTIC ~ HOLDING Ma,eria, No. of Compadments lq 1~11 IT TYPE OF SYSTEM ~ TRENCH ~ BED ~W. DRAIN ~ OTHER or,g,n.l grade ~, ~ FT ~, ~ FT ~,0 FT ~,~ FT ~lO FT ~'~j FT Total absorpbon area Distance between hnes ~/__ Nun, be, o' lines Pipe material .,~ WELLS ~ -.~:~ ~ ~1 ~ FTI FT REMARKS: / // I Scale: ~ ~~AL I ~ ~ ~ q~ emily thai Ibis inspectm~as pe~ acc0rdi.g t0 all Health Oepadment Approval: / ) ' * ~1 L ) Date: ~: ~ ~, ~,,- ' 72-013 (3/85) CONTACT I....E O:'~A L.. DEF'AF:(H"IE]',I~ O.F HEAI...*I'I"J Al'iD ENVIRONMENTAL. F'RO'TECTIOIxl 82.5 I.... S'I]:~EE'I", ANCHORAGE, AK 9950 1 2~64.-..4'7:~() S[}U]'H F:'ORK CONS'T. P,,O,, BOX 770567 I!i!:AGI..,E RIVER, AK 694434 1 995'77 I_OT SI ZE: MAX BEDROOMS SUBDIVISION: I:'IRE L. AKE SEC'I" I ON: 3:1 'T'OWNSH I F:': 2.. 5A (SQ. F:'"F. OR ACRES) L..[Fr: 4 :I. 5N RANGE: 1W BL. OCK: 'TRACT K L..iste<::l below are 'l:.he op'Lions available to you in des:igning your septic: system. Choose the op'l:,iorl t. hat best Fits your site. Dli!I:::'TH ]"[] I=' I F::'E B[)'T"I"OH (F:'l".) 4. () 4 ,, 0 4. () GRAVEL.. DEI='"[H (I::'T ,, ) 2.5 0,, 5 ~:~ ,, 5 T[]'TAI.,, DEI='TH (F'l".) 6.5 4.5 6,, 5 GRAVE:I- WIDTI"J (F't".) 2,, 5 18.0 5. () ['3RAVEl,,.. I,.,,ENE~'I'H (F'f'.) 84. C) ** 7;5.0 54. C) GI:b:~VI~:L, V(DI...,L.JIdI~: ([;U. YDS. ) 2:];. 4 2.:3.4 3C). 0 TANI'::: SI ZE (GAI,..S) 1, ()00.0 ** 1, OC)C). 0 ** 1, ()C)C),, () ** SOIL, RA'T'IIqE~ (SQ.F'T./BR) 140 140 14() ** GRAVEl_ LENG'I"H > '75 I=T'. Rla:QL,IIREEi MULT'I'F'LE I::~UNS (NOT EXCEli:.::DING '75 I:::"1",, EACH) ** TANK MI.IST HAVE A'T LEAST TW[] COMPAR"FI~IENTS I certit'y that: :/,, I am (am:i.].:i. ar' with the recluipemen'Ls ~'or orr,,.site sewers anct wells as set I'c)r'Lh by *Lhe Mun:[c:il::)ality of Anchor'age (MOA) arid the State of Alaska. :~],, I w:i.].l :i. nstall 'Lhe system in a(::cordance wi'Lh all M[]A c:oc:les and r'egulat:i, ons, and in comp].:i, an(:::e wi'Lh the des:i, gn criter':i.a c:)f' th:i.s per'mi'L,, 3. I ~J.:l.:l. adhere 'Lo al]. M[]A and SLate of Alaska requiremen'Ls ~'(::H" the s~t d:i.s'Lances ['rom any ex:i. sting ~e].l~ ~astewater' d~sposa], system or pul::)l:i, seweH"age system or'l th:i,s (:)P ar'ly adjac::eFIt oP i"~eal"by lc)t,, Zl.,, I under'stand tha'L this per'miL i~ valid ~'oP a maximum o[' 3 bedrooms and any en].argemerrL ~].]. r'equire al"i additional per, m~t. IF:' A I..,.IF']" STATI[)I',I IS II',IS'TALLED IN AN ARI:T.A COVERED BY MOA BUIL. DING [.]]DES, "l"HIi!~]q(1) AN EI....ECTRICAI... F'ERMIT AND INSPECTION MUST BE OBT'AINED; (2) AS-,..BUILTS WIL.I,,,. NOT BE AI:'PF~OVED WI'I"HOIJT' AN EL..EC, TF(ICAL INSPEC]"ION REF'ORT; AND C3) THE EL.E[::] RICAL WORK MUS'I" BE DONE BY A I_I(:ENDED EI...,ECTRIC, IAN. ~~SEAL) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES ~_~..j.....,~M~.c~,,......c~r¢~.~ 825 "L' Street, Anchorage, Alaska 99502-0650 ~";~~~ ~' ' SOILS LOG -- PERCOLATION TEST [~~~7~ ?,~'~' PERFORMED FOR: ~L~ ~ ~~ DAT ' '*z'~' LEGAL DESCRIPTION: L-a:~r ~,~ ~.~ t~,~ 2 3 7 9- Township, Range, Section: ,.'["'t~ ~,.~ , ,~.'~) .~_.~ '5 ~ SLOPE SITE PLAN / / / / / / / 10- 11 12 13- 14- 15- 16- 17- 18- 19- 20- WAS GROUND WATER Depth to Water Afl.er tJ Monitoring? Reading Date Gross Net Depth to Net Time Time Water Drop ~----- (minutes/inch) PERC HOLE DIAMETER __ PERCOLATION RATE .~ TEST RUN BETWEEN __ FT AND FT I PERFORMED BY: r ~(-'~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE: 72-008 (Rev. 4/85) S & $ ENGIt !EERING SRB 196X · EAGLE RIVER, AK 99577 5 — tae• • u �� t1LcMunicipality of Anchorage ��` On-Site Water and Wastewater Program SEP _61_1't■ ° (907) 343-7904 c , 12.' Certificate of On-Site Systems Approval `z al s a 9 Parcel I.D. 051-332-26 Expiration Date: — >� 1. GENERAL INFORMATION Complete legal description Fire Lake, Tract K, Lot 4 Location (site address) 19088 Fish Hatchery Rd. Current Property owner(s) Dunn Family Trust Day phone Mailing address 18515 Fish Hatchery Rd. Eagle River, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: • Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received b . 1111 _ A t Date: I 1 t v � / COSA to be released to the engineer,unless otherwise requested by a engineer. COSA Fee $ _57(, 1 315W Waiver Fee $ Date of Payment Cit Date of Payment Receipt Number C16 Receipt Number COSA# O3u Itfi6 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 that there are 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 Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 9/812017 ��OF ALgrki� 4- f r_ r*.49 N %\* 6! 6. DSD SIGNATURE "' • •" ,• System #1 Approved for bedrooms . R. 'annon ' / System #2 Approved for bedrooms 40'k c9� CE-8149 Disapproved (ik �11?OFESS�0 \\�� Conditional approval for bedrooms, with the following stipulations: `� OF ANCA , Q4. O GN_Sa VO yZ VOTER AND %a vi,STE RAt,A pROG _ . Q1F 0 `G�5 NTSER _ By: Original Certificate Date: 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 Advisor Septic System Advisory Arsenic Advisory • Well Flow Advisory }C Other -. _ COSA blue sheet r . ,. If more than 1 septic system is on the lot: COSA Checklist# 1 of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Fire Lake, Tract K, Lot 4 Parcel ID: 051-332-26 A. WELL DATA Well type Private If A. B or C provide PWSID# Well Log (Y/N) Y Date completed 9/10/2013 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 400 ft Cased to 44 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 9/10/2013 8/21/2017 Static water level Artesian ft 0* ft. Well production 0.3 9.11m. 0.6 g p m WATER SAMPLE RESULTS: Coliform*A colonies/100 mL Nitrate ON) mg/L Arsenic 1 V ug/L Date of sample: 8/21/2017 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/30/1986 Tank size 1 '0002 Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping ***7/2012015 Pumper JR's Pumping A f C. ABSORPTION FIELD DATA ' 146- 1-�' ii"v�° �`_s,z�e)6 g 4 �`��5�� v Date installed 7/30/1986 Soil rating (g.p.d./ft2 or ft2/bdrm) 140 SF/BR System type Shallow Trench Length 54 ft Width 5 ft. Gravel below pipe 2.5 ft Total depth 6'5 ft. Eff. absorption area 420 ft2 Monitoring tube Y Depression over field N 8/21/2017 Pass3 Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test 0 in Water added 536 gal. New depth 0 in. Elapsed Time: 100 min. Final fluid depth 0 in. Absorption rate >= 450+ g p.d. No Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes. give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 92** On adjacent lots 100+ Absorption field on lot 92** On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer/septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS *Well plugged so could not get measurement. Assumed 0 feet. Well has 600 gallons of storage. **Waiver on file WR#OSV151115 ***House vacant tank empty on 8/21/2017. G. ENGINEER'S CERTIFICATION y��»ku I certify that l have determined through field inspections and 1 • review of Municipal records that the above systems are in rt*g TH '',4\ .*�¶ conformance with MOA COSA guidelines in effect on this date. % . .. ..0 Engineer's Printed Name Steven R. Pan none . ':Sieves V.. aririorie , Date 9/8/2017 �6-0:,, CE-8149 •��/ COSA canary sheet_2-6-15.doc Municipality of Anchorage `•giliV . < r r'�' ri'iaa,z ui i° �_ Development Services Department _ Bid a Building Safety Division S A F E,Y On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On-Site Systems Approval (COSA) # OSC 171415 During a recent COSA on-site inspection and test of the potable water supply well on Block K, Lot 4 of Fire Lake subdivision, the well's productivity was determined to be .6 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3-bedroom residence is .31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. LOT lLOT ` Wood Power Pole Pole 1 589' OT E 330-49' Anchor Overhead rn Utility a J7\ Cables % a_ a r0 t� C N V 6O LOT 4 \ 0 a now TRACT K 11 m \ [-Wood Service ;23 4Pole In 23 LO1 L '; n m ' M f N pc, CP f!I Clean Out 0 e Well (TYP•)-----.....0 O O PCC • OWood Deck Pad a' p k Stai = _ Wood Landing ^ e al & Stairs 12 o e\Otag ^ 1B.4. 0'11r°j PCC Pad ,:., ' .5' qv :.4 A 3—Level Wood Frame Wood Stoi GtoJe\ Under Deck 9.• Residence Found. Wood Deck Ailli, orr 4.9, 4k Stairs 330.09' 1i N89'57'11"W LOT 0 LOT R • N 1 SCALE 1'=40' 0' 20' 40' Bo' NOTE; PREPARED FOR: Dimensions ore measured to the wood trim. DUNN W & D FAMILY TRUST I herebycertify that an accurate survey of the following described property: AS- BUILT ,`P pc '.DC7 Jf�r` LOT FIRE 4, TRACT AKE SUBDIVISION (P-111) 1*i45m *.A was mode on August 5, 2015 and that the improvements DWN. DATE GRID I, situated thereon ore within the property lines and do not overlap or JSP 8/19/2015 NW 0554 x encroach on the property lying adjacent thereto, that no • �qY w•k. improvements on the property lying adjacent thereto encroach on FILE NO. F.B. 2015 JOB NO. the premises in question and that there ore no roadways, 1547 PG. 34 1565 $ s�+3 S ?4� transmission lines or other visible easements on said property except 1 „6� as indicated hereon. Easements other than those shownrq on the /� /}C Gi +' ,,ss%%%%%% record plat may not appear on this drawing. KARl"1 BELNIKtJr F Anchorage Alaska, this 19th day of Auaust 2015. SURVEYING oma au-i.., �e • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Parcel I.D. 051-332-26 I ZZ� DgIOct/ 2-01,b Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: Complete legal description Fire Lake, Tract K, Lot 4 Location (site address) 19088 Fish Hatchery Rd. Current Property owner(s) Dunn Family Trust Day phone Mailing address 18515 Fish Hatchery Rd. Eagle River, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: Ej Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. _ NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El Individual 7 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Wafer System ❑ Public Sewer ❑ WaiverNariance request for: Received by:>_ Date: COSA to be released to the engineer, unless otherwise requested by the engineer. Date of Payment Receipt Number o ` Waiver Fee $ Date of Payment Receipt Number Waiver # x 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 that there are 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 Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for _a bedrooms System #2 Approved for bedrooms Disapproved Date 8/2/20116 Conditional approval for bedrooms, with the following stipulations: Ceib Icate Date: 42— t 5'tT 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 Septic System Advisory Well Flow Advisory COSA blue sheet t L c Nitrate Advisory . Arsenic Advisory Other ' If more than 1 septic system is on the lot:' COSA Checklist # 1 of Structure served by this system t Certificate of On -Site Systems Approval Checklist Legal Description: Fire Lake, Tract K, Lot 4' Parcel ID: 051-332-26 A. WELL DATA Well type Private if A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 9/%/2013 Sanitary seal (Y/N) Y Wires property protected (YIN) Y Total depth 400 ft. Cased to 44 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 9/10/2013 7/14/2015 Static water level AI'f2Slan ft 0* ft .pm. Well production 0.3 9.p -m -- 0.6 9— p.m-WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L (r Arsenic ug/L Date of sample: 27 4 Collected by: PV B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/30/1986 Tank size -1,000 gal. Number of Compartments 2— Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (YM) N Date of pumping ***7/20/2015 Pumper JR's Pumping C. ABSORPTION FIELD DATA Date installed 7/30/1986 Soil rating (g•P• d./ft2 or ft ) Y yP2/bdrm 140 SF/BR S stem t e Shallow Trench Length 54 ft. Width 5 ft, Gravel below pipe 2.5 ft. Total depth 6.5 ft.. - Eff; absorption area 4.20 ft2 Monitoring tube Y Depression over field N Date test 7/14/2015 Results Pass 3 of adequacy (Pass/Fail) For bedrooms Fluid depth in absorption field before test 0 in. Water added 536 gal. New depth 0 in. Elapsed Time: 100 min. Final fluid depth 0 in. Absorption rate >= 450t g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No if yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: , Septic tank/lift station on lot 92** On adjacent lots 00+ Absorption field on lot 92** On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line, 0+ Surface water 100+ Wells on adjacent lots .100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS *Well plugged so could not get measurement. Assumed 0 "feet-. Well has 600 gallons of storage. **Waiver on file WR#OSV151115 ***House vacant tank empty. G. ENGINEER'S CERTIFICATION 5-00F I certify that i have determined through field inspections and S review of Municipal records that the above systems are in *41, conformance with MOA COSA guidelines in effect on this date. CIA Engineer's Pannone Engineer's Printed Name .$levan Pannone : Date � 8/2/2016'.• CE 8149 COSA canary sheet 2-6-15.doc - Municipality of Anchorage u Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC 151483 During a recent COSA on-site inspection and test of the potable water supply well on Block Tract K, Lot 4 of Fire Lake subdivision, the well's productivity was determined to be 0.6 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. 0 Parcel I.D. 051-332-26 pcS e� Municipality of Anchorage 1A On -Site Water and Wastewater Program (907) 343-7904 c s< e c r n Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Fire Lake, Leri Expiration Date: /a _/ _6- 11R K Location (site address) 19088 Fish Hatchery Rd. Current Property owner(s) Dunn Family Trust Day phone Mailing address Real Estate Agent 18515 Fish Hatchery Rd. Eagle River, AK 99577 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well I] Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNadance Received by: / /\I"" ` `'V"V — Dater J COSA to be released to the L04er,lunless otherwise requested by the engineer. COSA Fee $ Jui Waiver Fee $ Date of Payment q/Z165� G114— Date of Paymentg/iS Receipt Number dit 1 i1 Receipt Number 62b(n SGi COSA # n 5 c i 51 ` ?_3 Waiver # QW 151115 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 that there are 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 Phone (907) 272-8218 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 Date 9/1/2015 Conditional approval for bedrooms, with the following stipulations: By: �� A/ Original Certificate Date: I — s =�� The Mi ' Ii f orage 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 X_ Other COSA blue sheet S :., c If more than 1 septic system is on the lot: COSA Checklist # + of Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Fire Lake,;' }- [ f TpParcel ID: 051-332-26 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (YIN) Y Date completed. 9/10/2013 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 400 ft. Cased to 44 ft. Casing height (above ground) 18+ in. FROM WELL LOG-- AT INSPECTION Date of test 9/10/2013 7/14/2015 Static water level Artesian ft 0 ft Well production 0.3 g.p.m. 0.6 g.p.m. WATER SAAB RESULTS: Coliform Neg colonies/100 mL Nitrate 0.506 mg/L Arsenic ND ug/L Date of sample: 8/5/2015 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,000 gal. Number of Compartments 2 Foundation cleanout (YIN) Y Depression over tank (Y/N) N Date of pumping 7/20/2015 Pumper JR's Pumping Date installed 7/30/1986 Cleanouts (Y/N) Y High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed 7/30/1986 Soil rating (g.p.d.tft2 orftz/bdrm) 140 SF/BR System type Shallow Trench Length 54 ft. Width 5. ft. Gravel below pipe 2.5 ft. Total depth 6.5 ft. Eff. absorption area 420 fe Monitoring tube Y Depression over field N Date of adequacy test 7/14/2015 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. . Water added 536 gal. New depth 0 in. Elapsed Time: 100 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at in. 'Pump off' level at Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: AW Septic tank/lift station on loth** 91- b Absorption field on lot * q&, ! Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 50+ SEPTICIHOLDING TANK ON LOT TO Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 160+ Holding tank 100+ Manure/animd*6rete storage areas 100 Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+_: Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ - ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ Water main 10+ Driveway, parkinglvehicle storage 10+ in. F. COMMENTS *Well plugged s0 could not get measurement. Assumed 0 feet. **See attached Waiver request. Well has 600 gallons of storage. G. ENGINEER'S CERTIFICATION I certify that t 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 9/1/2015 COSA canary sheet 2-6-T5.doc L l)T I i nT LO LO' NOTE: Dimensions are measured to the wood trim. I hereby certify that an accurate survey of the following described "\ii property: IF.q/�% LFIRE OT 4LAKE SUBDIVISION (P-111) AP was made on August 5, 2015 and that the improvements „; ..0' situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no krnbetnikof f:$ improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, 3143-5,,� f transmission lines or other visible easements on said property except as indicated hereon. Easements other than those shown on the record plat may not appear on this drawing. Anchorage Alaska, this 19th day of August 2015. i i SCALE: 1 "=40' 0' 20' 40' 80' ie LSI M UJ V 1 A Municipality of Anchorage No m�nt ks P.O. Box 196650 : 4700 Elmore Road y Anchorage Alaska 99519-6650 • (907)343-7904 •Fax 19071 343-7997 Wepparstmeent httwilwww.mun i.ornlOns ite Development Services Division **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV151115 COSA#:OSCIS1483 Permit#: PID#: 051-332-26 Legal Description: Fire Lake Lot 4 Tract`K Engineer: Pannong Engineering SServices. _ - -- Applicant: Dunn Family Trust Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the private well has been approved. The approved separation distance is 90.0 feet to the tank and 95 feet from the well to the absorption field. This waiver -approval applies to the existing absorption field and septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s), of the affected adjacentproperty. ® Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: /� /✓� Approved by: Name of Regi wer ..-.r.t•.....'.......a.......... r ..................0 i�....• ................ r.:.. **** VARIANCEMAIVER REVIEW **** Fire Lake, Lot 4 Tract K Parcel ID: 051-332-26 Waiver from well to tank for 90 feet and to field 95 feet 8/9/2015 General 1. If the septic systems overflows it will flow away from the well. 2. Lab results show nitrate levels to be 0.5 mg/I. ADEC Criteria Water Table Depth to water bearing layer Depth of tank Points 375 feet 6.5 feet 368.5 feet 8.1 Soil Sorption (well loq shows all bedrock, info from 1986 soils loo used Soil descriptions DEC PTS Depth From Depth To Thickness Calc. Pts GP(140 soils rating) 1.5 6.5 10.5 4 1.50 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 4 1.50 2.0 Permeability Soil descriptions (well log shows all bedrock, info from 1986 soils log used) DEC PTS Depth From Depth To Thickness Calc. Pts GP(140 soils rating) 1 6.5 10.5 4 1.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 4 1.00 1.0 Water Table Gradient - Per engineer 2.9 Horizontal Separation 90 feet 2.6. Total Points 16.6 As per ADEC waiver guidelines, with a minimum point value of 16.6, almost sure to be free from any form of contamination from household sewage. Waiver is approved. Pannone Engineering Services «c Steven R. Pannone, Principal Registered Professional Engineer E-mail: Steve@panengak.com September 10, 2015 Subject: FIRE LAKE TRACT K LOT 4 _ Waiver of Septic Tank and Absorption Field to Well Separation Distance Request This is a waiver request for a septic tank and absorption field to well separation distance for the above reference property. The existing 1000g tank is 91.8'± and the existing drain field is 96.1'± from the existing private well on the property. These separation distances for the existing system required a waiver. 1. Waivers: We would like to request a waiver for separation distance for the existing septic system (tank and absorption field) to the well located on the lot with the details specified below. a. Septic Tank (E) to Well (E) & Absorption Field (E) to Well (E): We are requesting waiver for the separation distance waivers between the existing well to the existing septic tank and to the existing absorption field. We are requesting a waiver for both the septic tank and the absorption field to the existing well to a distance of 90' and 95' respectively. i. DEC Criteria: The well on FIRE LAKE TRACT K L4 is a private well and was drilled in 2013. The data is summarized as follows: LOT ## WELL STATIC YIELD Well Data H20 Test Soil Well Log Nitrate DEPTH WATER LEVEL Date Date Characteristics Data Level FIRE LAKE 400' 0' 0.6 gpm 9/10/13 08/17/15 Y Y 0.506 TR K L4 FIRE LAKE 325' 50' 0.3 gpm 07/21/86 08/06/76 Y Y Unk TRAL4 FIRE LAKE 152' 15' 0.03 gpm 06/21/74 Unk Y Y - Unk TRLL4 The ground water in this area typically flows from the east to the west beneath a deep layer of bedrock / fractured bedrock. The soil cross-sections are similar across the area and a homogenous cross-section was used to calculate the DEC criteria for all components. As outlined under 18 AAC 80.020 and 18 AAC 72.021(a), I have calculated the following points: Lot 6 & Lot 7 Seotic Svstem to Well: Distance from sewer system bottom to groundwater 8.15 Soil sorption below sewage system 4.84 Soil permeability below the system 1.97 Water table gradient 2.90 Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 Horizontal separation Total Points 2.64 20.49 "The sum of the above values could equate to the following conditions: 16-24 Almost sure to be free from any form of contamination from household sewage." in my opinion, this waiver request meets the above criteria for approval and does not constitute risk to health. I hope the above information will assist you in determining that the waiver should be granted. The installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211