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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 .~. ...... ~_..~ _ ~-~ .... Z_=. .~_1_' ~'~'~ - _ . ~ -... ./ .4 , , i ~ k l'" '~'"'' ~ ~ / //'' ". ~ DUPlEX(P) ~ %1 ,~" , ~ /DUPLEX(P) N. , x. ~ ~.--/-t- ,-~ , I~ .' N ......... . ~ / ~, ,.- /1! x , ~¥. _ / ~ ~, :V'---'" ~// x, --'" --" ~ .... -, ,' x ~ IX~ r, ~ ~ I, Ok N -/ / ~ ~ X ~ ~ .... ~ - ~ w~l / U s~ I / / ~ / I , ml 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~ e • ac v i V 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.