HomeMy WebLinkAboutSAND LAKE #2 BLK 1 LT 24$ond Lol<e
Block
Lot
#011-132-01
Certified Drilling Log
�B,LIL -& r -O LE o��Da�
ULLIVANWATrER WELLS
ePP.O. Box 670269, g
OWNER OF LAND: Spinell Homes
ADDRESS: 1900 W. Northern Lights Blvd #200, 99517
LEGAL DESCRIPTION Sand Lake #2 Block 1 Lot 24
DATE: " 9-28-15
PERMIT NUMBER: OSP151258 DATE OF ISSUE:
_8-10-15 -
TAX IDENTIFICATION NUMBER
01113201000
2
Is well located at approved permit location: ®Yes
No
Method of Drilling: ®air rotary ❑cable tool
Overburden
Depth of Well: 200'
82
Silt & Sand w/ Gravel
Casing Type: Steel
Wall thickness ,250
inches
Diameter: 6
inches, depth 198
feet -°
Liner type
160
Silt & Sand Water
Static Water Level: 86
185
feet
Recovery Rate 10
Ej gpm ❑
gph
Method of Testing Air
200
Tight Sand & Gravel
Well Intake Opening Type:
open end open
hole
❑ Screened Start
feet - Stopped
❑ Perforations Start
feet Stopped
Grout Type: Bentonite Volume:
50 lbs
Depth: from 2
feet, to 42
feet
Well Disinfected Upon Completion: ❑yes ❑ no
Method of Disinfection: Chlorine 50 PPM
Comments
Bore Hole Data
Depth
From
To
0
2
Casing Stickup
2
4
Overburden
4
82
Silt & Sand w/ Gravel
82
90
Silt & Sand Water
90
110
Sand & Silt w/ Coal
110
160
Silt & Sand Water
160
185
Clay
185
190
Clay & Gravel
190
200
Tight Sand & Gravel
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.
HILL .4 crit DOC CO dba
,,,,. , ULLIUAN WATER WELLS
' PO. Box 670269, Chugiak, AK 99567 688-2755
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: SW OSPI51258 Date of Issue 9-28-15
Parcel Identification Number: 01113201000
Legal Description
Sand Lake #2 Block 1 Lot 24
p Pump Installation Date: 6-23-16
Pump Intake Depth Below Top of Well Casing: 190
Pump manufacturer's Name: Goulds
Pump Model: 7HS07412CL
Pump Size: 3/4
Pitless Adapter Burial Depth: 10
Pitless Adapter Installer: Pomraning Excavation
Disinfected Upon Completion? ® yes ❑ no
Method of Disinfection: Chlorine 50 PPM
Comments: Pitless Manufacturer: Martinson
11 Pump Installers Name: Sullivan Water Wells
Property Owner Name & Address
Spinell Homes 1900 W. Northern Lights Blvd #200
Anchorage, AK 99517
feet
hp
feet
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
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: OSP'151258
Tax Code Number: 01113201000
Work Type: Well Initial
Permit Effective Dates: August 10, 2015
to August09, 2016
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: SAND LAKE #2
Site LegalAddress: SAND LAKE #2 BLK 1 LT 24 G:2224
Owner/Address: PATELLA DENNIS
8031 WILCOX STREET ANCHORAGE AK 995024151
Site Mailing Address: 5116 W 80th AVE, Anchorage
Lot Size in Sq Ft: 6750
Total Bedrooms: 6
Department
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 Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AACS0).
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
P.O. Box 196650 · 4700 Elmore Road
Anchorage, A aska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997
htto:llwvcw.muni.omlOnsite
Development Services Division
On-Site Water and Wastewater Prooram
mpartment
**** VARIANCE/WAIVER REVIEW ****
Waive~: OSV151098. COSA#:. Permit: OSP15t258.
PID#: 0t t-132-0t
Legal Description: Sand Lake #2. Block 1. Lot 24
Engineer: PES
.Applicant: SDinnel Homes
Your request for a waiver of the required 100 feet horizontal separation from the
public sewer manhole to the private well has been approved.' The approved separation distance
is 60.0 feet.
Your request for a waiver of the required 75 feet horizontal separation from the
public sewer trunk to the private well has been approved. The approved separation distance is
55.0 feet.
This waiver approval applies to the proposed well only.
[] The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
[] Notarized letter(s) of non-objection have been received from the owner(s) of the affected
adjacent property.
[] Adjacent properties are not affected by this waiver.
Wal~er is Granted: X Waiver is not Granted:.
Date: Approved by: '
L,~lame of Reviewer
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELt. PERMIT APPLICATION
Parcel I.D. 011-132-01
Property owner(s) Spinnell Homes Day phone None Available
Mailing address 1900 W Northern Lights BIvd #200, Anchorage, AK 99517
Site address NHN Endicott St, Anchorage, AK 99502
Legal description (Sub'd., Block & Lot) SAND LAKE #2, B1 L24
Legal description (Township, Range & Section)
Lot Size 6750 .Sq. Ft. Number of Bedrooms 6
APPLICATION IS FOR: APPLICATION IS.AN: TYPE OF DWELLING:
([~ all that ~pply)
Absorption Field [] Initial [] single Family (SF) []
(w/we ADU)
Septic~ Tank [] Upgrade [] Duplex (D) []
Holding Tank [] Renewal []
M utti~le Dwellings []
Privy [] (SF and/or D)
Private Well []
Water Storage []
THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR:
Well to Public Sewer Manhole.separation distance Distance: 60'
I certify that the above information is correct. I further c~rtify that this is in accordance with
applicable Municipal Codes.
~'~or authoriZed agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number:
Permit No.
Waiver
Date of Payment:
Receipt Number:
Waiver No.
Permit App_:~- :-: 2.Jo ~'
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional En§ineer
E-maih steve@panengak.com
5 August 2015
Subject:
SAND LAKE #2, BI' L24
Well Permit Request
Design Narrative
This is a design ~arrative for a permit to install an initial private well to be issued for this property. The
proposed system will serve a proposed six (6) bedroom duplex. Currently the lot is undeveloped. The
surrounding deve!oped lots are served by a combination of Class C Community wells and private wells.
The proposed development will connect to city sewer.
1. Drawing Markings: The Drawings are marked "FOR CONSTRUCTION".
Waivers: Due to size of lots and proximity to existing public sewer lines a Well to Public Sewer
~"Manhole separation distance waiver to 60' is required. The manhole is downslope from the well and
should have no impact on the well. In regards to subsurface impacts, the hydrologic gradient of the
ground water in area slopes from the southwest to the northeast at approximately a :16% grade away
from the well. In regards to surface impacts, there is a storm drain system located between the
manhole cover and the proposed development area that would catch overland sheet flow from the
manhole that doesn't move along the natural lines of drainage along 80th Ave from west to east.
d ii~ot affect the future development of this or the surrounding lots.
"'
Mailing: P.O. Box 100217, Anchorage, AK 995:10-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-821:1
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SPECIAL PROVISIONS TO SPECIFICATIONS
1. SCOPE OF WORK: INSTALL WELL (P) lAW MOA CODE 15.55.
os/oM~
~o~ OONST~,:,O, ,.0. ,0X ~00~ *,C,0,A0~, AX ~0 ~.." .... ~:~ff¢]i, ~,~
PHONE (907) 272-8218 FAX (907) 272-8211 ~."
~...~ ...t~ 1"=~o'
DRAWN I JRL NHN ENDICOTT ST ' OSP151258
~~ Sheet
PLA~ A,CHO~AOC AX 99S02 ~) ~ ~ o~
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Parcel I.D. 011=< 32-01
CP2
Municipality of AnchorOn-Site Water and Wastewater Progr
(907)343-7904
Certificate of On -Site .Systems
1. GENERAL INFORMATION
Expiration Date: _l 2• -(,::,-1(p
Complete legal description Sand. Lake #2, Block 1, Lot 24
Location (site address) 5116 W 80th Ave.
Current Property owner(s) Spinell Homes Inc Day phone
.Mailing address 1900 W Northern Lights Blvd. #200 Anchorage, AK
Real Estate Agent Day phone
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
99517
3. NUMBER OF BEDROOMS:
6
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
E
Individual
❑
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
0
WaiverNariance request
Received by: .eff:�Date:
COSA to be released to the engineer, unless otherwise re sted by the engineer.
COSA Fee $ W.&S
Date of Payment—... 14WI&
Receipt Number Olaua6
COSA #
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
s
i
5. STATEMENT OF INSPECTION BY; ENGINEE9 ;' 4
As certified by my seal affixed hereto and as of the validation "date shown -belowp' I verify th'Ri my investigation, based on procedures outlined
in the Certificate of On -Site Systems Approval GOidelines for this,applicati6n, shows tOt the on-site water supply and/or wastewater
disposal system is (are) safe, functional and adequate for th2 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) incompliance 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 endountefsd at iia ti of A tett,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on 1 he local soil
condition, ground water levels that may fluctuate during the year, and the water usage of the family being served•by.theiasysten . Thee conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test resuR's,�do not. guaragqtee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefo4we cannot provide ari Warfarffy-
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 Alk. 99510
Engineer's Printed Name Steven R Pannone
6. DSD SIGNATURE
System #1 Approved for _�2_ bedrooms
System #2 Approved for bedrooms
Disapproved
Date 9/2/2016
Conditional approval for bedrooms, with the following stipulations:
By: w✓ := c%�— C Original Certificate Date: 1 -rte — b
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:
c;,'
COSA Checklist X Nitrate Advisory '
Septic System Advisory Arsenic Adiyisor'y •, _`-
Well Flow Advisory Other
COSAbluesheet f c
If more than 1 septic system is on the lot:
COSA Checklist # + of
Structure served by this system 1
Ceffificate of On -Site Systems Approval Checklist
Legal Description:. Sand Lake #2, Block 1, Lot 24 Parcel ID: 011-132-01
A. WELL DATA
Well type PI IVatejf A, B, or C provide PWSID # Well Log (YIN) Y
Date completed 9/28/2015 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 200 ft. Cased to 198 ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 9/28/2016 New
Static water level 86 ft. New ft
Well production 10 g.p.m. New D.D.M.
WATER SAMPLE RESULTS:
Coliform Neg colonies/100 mL Nitrate 0.322 mg/L
Arsenic `N70ag/i Date of sample: 8/23/2016
�9'"
B: SEPTIC/HOLDING TANK DATA
Tank Type/Material
- Tank size gal. Number of Compartments
Foundationcleanout (YIN). Depression over tank (Y/N)
Date of pumping Pumper
C. ABSORPTION FIELD DATA
Collected by: PES
Date installed
Cleanouts (Y/N)
High water alarm (Y/N) _
Date installed Soil rating (g.p.d.lft2 or ft2/bdrm) System type
Length ft. - Width ft. Gravel below pipe ft.
Total depth ft. Eff. absorption area ft2 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 >= 9-P.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
If yes, give date
G. ENGINEER'S CERTIFICATION
1 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.
Engineer's Printed Name Steven Pannone
Date 9/2/2016,
COSA canary sheet_2-6-15.doc -
D. LIFT STATION,,
Date installed Size in gallons
Manhole/Access {Y/N)
"Pump on" level at in. "Pump off" levelat `
in. High water alarm level at in.
Datum Cycles tested
Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
=
WELL ON LOT TO:
Septic tank/lift lot N/A
100+
station on
On adjacent lots
Absorption field lot N/A
100+
on
On adjacent lots
Public sewer main 75+
Public sewer manhole/cleanout qE)O+ 5,61
Sewer /septic service line 25+
Holding tank 100.1-
Animal containment areas 50+
Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO: .
Building foundation Property line
Absorption field
Water main Water service line
Surface water
Wells on adjacent lots
ABSORPTION FIELD ON LOT TO:
Property line Building foundation
Water main
Water Service line Surface water
Driveway, parking/vehicle storage
Curtain drain Wells on adjacent lots
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 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.
Engineer's Printed Name Steven Pannone
Date 9/2/2016,
COSA canary sheet_2-6-15.doc -
I
Municipality of Anchorage
+rx r
Development Services Department s��=°=
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Arsenic Advisory
Certificate of On -Site Systems Approval # OSC161397
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 1, Lot 24 of
Sand Lake #2 Subdivision. This inspection revealed an arsenic concentration
of 78.2 micrograms per liter (ug/L) for the property's well water sample.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 ug/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. Information on arsenic is
available from the On -Site Water and Wastewater Program website
(w=.muni.org/onsi ) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.