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HomeMy WebLinkAboutALPINE VILLAGE BLK 3 LT 17Alpine Village Block 3 Lot 17 #014-133-35 r 04/13/2016 22:04 907-345-0202 ALPINE DRILLING PAGE 02/02 Development Services Department Building Safety Division On-Site Water & Wastewater Program4700 Elmore RoadP.O. *AC Bax 196650 Anchorage, AK 99507 Mark Begich mayor www muni ora/onsfte ' (907) 343.7904 Pump Installation Log Well Drilling Permit Number: SW 141076 Date of Issue: 4-17-14 Parcel Identiticat1011 Number; 1413335000 Legal Description Property Owner Name & Address: Hannah Joseph & Modesta PO Box 110316 Alpine Village Bik3 Lot 17 Anchorage, AK 80511.0318 pump Installation Date: 612rV14 pump Intake Depth Below Top of Well Casing: 97 feet pump Manufacturer's Name: Goulds Pump Model: 7sB05 Pump Size 112 by pitless Adapter Burial Depth: WA feet pitless Adapter Manufacturer's Name: Marlenson Pitless Adapter Installer: nlrA Well Disinfected Upon Completion? W] Yes 0 No Method of Disinfection: olodnetablets Comments: Pump Installer Name: Aarow Pump & well Service, LLC P.O. Box 1104N Anchorage,AK 99511-0496 Attention: The pump installer shall provide a pump installation log to the ASA within 30 days of pump installation. !1 ?< I 1►�41Ii�,�i Alpine Drilling & Enterprises Well Log Permit Number: #SW 141076 Date of Issue: 4-17-14 Parcel Identification Number: 1413335000 Date Started: 4-25-14 Date Completed: 5-1-14 Is well located at approved permit location? x Yes ❑ No Legal Description: Alpine Village Blk 3 Lot 17 Property Owner Name & Address: Hannah Joseph & Modesta PO Box 110318 Anrhnrana dlaclen 00F41 _ V Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To V v Method of Drilling x air rotary ❑ cable tool Casing type: steel Stick-up 0 1.5 Wall Thickness:.250 inches Organics & silt. 1.5 4 Diameter: 6 inches Depth: 101 feet Gravelly silt 4 11 Liner Type: Diameter: inches Depth: feet silty sandy gravel 11 13 _ Casing stickup above ground: 1.5 feet silty gravel 13 16 Static water level (from ground level): 18 feet gravelly silt 16 68 Pumping level: 100 feet after silt 68 72 2 hours pumping 15 gpm gravelly silt 72 90 Recovery Rate: 15 gpm Method of Testing airli —. gravelly sandy silt H2O 90 98 Well Intake Opening Type: water sand & gravel 98 101 x Open End ❑ Open Hole ❑ Screened Start —feet Stopped feet ElPerforations Start feet Stopped _ feet Grout Type: bentonite anules Volume: 2 bgs De the Start 0 feet Stopped ? feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? x Yes ❑ No WATER QA1A• L $IING Method of Disinfection: chlorine tablets ColKorm C01/10oRll. Comments: Nitrates N P rngll Arsenio _ �. 7 tl U94- Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 On-Site Water System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141076 Tax Code Number: 01413335000 Work Type: Well Initial Permit Effective Dates: April 17, 2014 to April 17, 2015 Design Engineer: Subdivision: ALPINE VILLAGE Site LegalAddress: ALPINE VILLAGE BLK 3 LT 17 G:2133 Owner/Address: HANNAH JOSEPH & MODESTA PO BOX 110318 ANCHORAGE AK 995110318 ~artmez~t Site Mailing Address: 7217 Basel ST, Anchorage This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank Lot Size in Sq Ft: 8450 Total Bedrooms: 3 N Privy Y Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On-Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWERNVELL PERMIT APPLICATION Parcel I.D. OI~F~'OOO Property owner(s) '~'o$¢~H ? ~ob c~ H q ~q~ Mailingaddmss ~o ~o~ Jlo31~ ~c~,o~ Site address 7~J~ ~SCL ~ Legal description (Sub'd., Block& Lot) ~l pJ~c U; ilq~( ~cC ~ Legal description (Township, Range & Section) Lot Size ~oO Sq. R. Number of Bedrooms ~ Day phone 5'3~/~lo'7//$:2~ lo-t 17 APPLICATION IS FOR: ([;~ all that apply) Absorption Field [] Septic Tank [] Holding Tank ' [] Pdvy [] Private Well .~ Water Storage [] APPLICATION IS AN: Initial [] Upgrade [] Renewal [] TYPE OF DWELLING: Single Family (SE) (w/wo ADU) Duplex (D). 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. (Signature/el property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. 'C~I~'-- ~-~"~l~'- Waiver Fees: ~-'~//.~ ~/' ~.~ Datelof Payment: 1'=~::~-"~~ ~ Receipt Number: 05 P/~/Z~ Waiver Nol. Pen~it App_9-1 - 12.doc 9//~L9 :~d/~ @6OlliA ~ >13ol8 NVqd _LOqd LEI g ,O0'OC~ 9L ~ ,,00,6~o69 S qouuoH eol' /_~ 101 %r-/OH '-'.'.'-Q3AVd Q350dOSd-'- ,g'tO t=b~OO"d Q(31~INL-I (]%OdO~Jd ,00'0~[ 3 ,,00,6~o69 N Z CLE~qOUT 12~13 .? 30' 30' 30' 9.,54.3 6 5 4 :5 2 6� 19 77 -o �G E• • / •` _•-� . icipality of Anchorage al Ni{ zol6 s k ite Water and Wastewater Program "1161 h 1, (907) 343-7904 SA ETY `ya CUk) a 6 . • icate of On-Site Systems Approval Parcel I.D. 014-133-35 Expiration Date: (D 1. GENERAL INFORMATION: Complete legal description Alpine Village: Block 3, Lot 17 Location (site address) 7217 Basel Street*Anchorage,AK 99507 Current Property owner(s) George&Janice Enquist Day phone (509)690-3248 Mailing address Real Estate Agent Tina Steenmeyer Day phone 223-9319 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 ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer WaiverNariance request for: Distance: Received by: / Date: 34/49, COSA to be released to e engineer,unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of P nt 1ar Date of Payment Receipt Number l Receipt Number COSA# 05U g-I O r 1 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road,Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 3/.C/lg pOOQ. ,N, In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system OF A \ Q in accordance with the guidelines and regulations established by the Municipality of Anchorage and _,.=:=,.`c•.•••...•••., 4s0,, industry practices. The reported results describe the condition of the system/s on the date/s of the 4 1) evaluation. Separation distances were measured to readily identifiable features. Hidden defects or �.� encroachments may exist that were not identified during the evaluation. The operational life of all wells Q�*. 4 TH .•37°0 0 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, ' Q groundwater levels (that may fluctuate during the year), quality of construction (materials and 4 VA workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and /... i .,. . p are outside the control of GEG. Satisfactory test results do not guarantee future performance of theJ f - . Games ;• system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of V0 g ' I,CE / `p� the well or septic system. GEG makes no representation whether an alternative well or septic system 14,3C �� • •, .ceQ can be installed on the property in the event either of the current systems fail to perform adequately in ��f�', v�/S./(3. F,% the future. The content of this report is for the sole benefit of the person/party that retained GEG to ,lea o� o rofesSIO. o perform the evaluation. Reliance upon the information provided in this report by any other person or �DOOp004 - party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE KSystem #1 Approved for - bedrooms System #2 Approved for bedrooms P\S-\y OF Aiv. Disapproved - \CLQ O �, JON-SITE ��. Conditional approval for bedrooms, with the follctiving0iJ WASWAo T PROGTEKAM TER ��� ')���, TS�Rv�G)� r �'—j,l it , "i.^Ig Original Certificate Date: 2-0 -/C 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 engineers work. 7. ATTACHMENTS: COSA Checklist X- Nitrate Advisory Septic System Advisory / Arsenic Advisory Well Flow Advisory Other COSA blue sheeLl 0.10.12.doc rc) --,„ 6 ... „.. If more than 1 septic system is on the lot: LI MAR 1 3 LU,3 3 COSA Checklist# of ts. ti Structure served by this system L �w Certificate of On- �` ,- 41 ..:4 ms Approval Checklist Legal Description: Alpine Village; Block 3, Lot 17 Parcel ID: 014-133-35 A. WELL DATA Well type Private If A, B, or C provide PWSID# N/A Well Log (Y/N) Yes Date completed 5/1/2014 Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes Total depth 101 ft. Cased to 101 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 5/1/2014 8/2/2016 Static water level 18 ft. 27 ft. Well production 15 g.p.m. 2.4+ g.p.m. WATER SAMPLE RESULTS: ColiformC colonies/100 ml. Nitrate N"mg./L. Collected by: GEG. Ltd. ( Arsenic: I JOug./L. Date of sample: 3/6/2018 B. SEPTIC/HOLDING TANK DATA PUBLIC Tank Type/Material Date installed Tank size gal. Number of Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) Depression over tank (Y/N) High water alarm Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2or ft'/bdr System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption . -a ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absor. field before test in. Water added gal. New depth in. Elapsed Ti • min. Final fluid depth in. Absorption rate >= g.p.d. • . 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 .. wa er alarm level at in. I- •• Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A 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 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: PUBLIC Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIE 0 : i OT TO: Property line Bu. •.- • oundation Water main Water service line Surface water Driveway, parking/vehicle storage . n drain Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION o OFA 1 QQ�P,�� r�.- I certify that I have determined through field inspections and f : 4!IH . •••"7"OQ review of Municipal records that the above systems are in g VA conformance with MOA COSA guidelines in effect on this Q date. Q •.Je -y •. , s• Engineer's Printed Name JEFFREY A. GARNESS QO E 79 3 opt p0-s� � • � ,a••� .,goo Date 3/i(//473 Q��' 3 .��.. o oAo / 'Zr fession o \0 �o�� #AECC884 (Rev.11/05) 771 6� RUSHY I" Municipality of Ancho e On -Site Water and Wastewater Prog AUG ® 9 (907)343-7904 Certificate of On -Site Systems Parcel I.D. 014-133-35 1. GENERAL INFORMATION Expiration Date: I I Q 1 o Complete legal description ALPINE VILLAGE; LOT 17, BLOCK 3 Location (site address) 7217 Basel Street `Anchorage 99511 Current Property owner(s) Mailing address Real Estate Agent Gordon Sloane 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 205-7477 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well © Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer lid WaiverNariance request for: NIA Distance: N/A Received by:i Date: I Q / /6 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ j• �DD Date of Payment Bf 10NO Receipt Number 1096916 _ COSA# r� wn� a 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. Name of Firm Gayness Engineering Group, Ltd. (GEG) Phone (907) 337-6179 Address 3701 E. Tudor Road, Suite 101, Anchorage AK, 99507-1259 J Engineer's Printed Name Jeffrey A. Garness Date k Gj , In conducting this evaluation, GEG provided an engineering evaluation of the well and/orseptic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system's on the dates of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system's,' therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well orseptic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short GEG disavows any legal duty to anyone other than the person/party who paid for this report. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the following OFA/VC' �� Si1E ��' `•. �EwPTER 0, tat%hs. OORPt`A Original Certificate Date: q — /o -1 to 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 _ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet- 1-12dm If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: A. WELL DATA ALPINE VILLAGE; LOT 17, BLOCK 3 Parcel ID: 014-133-35 Well type PRIVATE If A, B, or C provide PWSID# NIA Well Log (Y/N) YES Date completed 511/2014 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 101 ft. Cased to 101 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 5/1/2014 8/2/16 Static water level 18 ft. 27 ft. Well production 15 g.p.m. 2.4+ g. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate N►O mg./ .v Arsenic: O.3°ug./L Date of sample:- 8/2/16 B. SEPTIC/HOLDING TANK DATA AWWU Tank Type/Material Tank size gal. Number of Compartments Collected by: GEG, Ltd. Date installed Cleanouts(Y/N) Foundation cleanout (Y/N) _ Depression over tank (Y/N) _ High water alarm Date of pumping C. ABSORPTION FIELD DATA Date installed Length ft. Total depth ft. Eff. Date of adequacy test Pumper Soil rating (g p.d./feor fP/bd System type Width ft. Gravel below pipe ft. bsorptio a ft2 Monitoring tube_ Depression over field Results (Pass/Fail) For bedrooms Fluid depth in absor ' n field before test— in. Water added — gal. New depth _in. Elapsed T' _ min. Final fluid depth _ in. Absorption rate >= - g.p.d. Arif-rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Sae in gallons Manhole/Access "Pump on" level at in. "Pump oft" level at r alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot WA On adjacent lots Imo'+ Absorption field on lot WA On adjacent lots Public sewer main 75'+ Sewer /septic service line 2'+ Public sewer manhole/cleanout 700'+ Animal containment areas W+ Manure/animal excrete storage areas fes'+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: AW WU Building foundation Water main Wells on adjacent lots Property line Absorption Water service line Surface SEPARATION DISTANCE FROM ABSOR=undatlon_ OT TO: Property line Water main Water seryice lin Surface water Driveway, parldnglvehicle storage Wells on adjacent lots F. COMMENTS 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 guldeglnes in effect on this date. Engineer's PdN me JEFFREY A- GARNESS Date le 01 �/L (Rev. 1011212) 1R1L4L007 / ) ! e7 «|f � � &\ �..�^-If7 .�� ƒ/\/ƒ\ ' 13EVO - ,00-99 MH 0 � /oN � �k/ / E; 0 az 2 ƒ \ l | ƒ »° o 14.1 / } @ 2 \ w.ki� , CONC. § $ \ |z £ \0 , \ e_2ue�a�01 �� &0 99 ±00,Lo oos k j } � $�