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HomeMy WebLinkAboutNORTH SLOPE #2 BLK 4 LT 14Wheaton Water Well, Inc. 1190 N. Wasilla-Fishhook Road Wasilla, AK 99654 (907)376-2041 Name: Todd & Kris Jedlicki Address: 30950 Sagwon Avenue City: Eagle River State: AK Zip Code: 99577 Well Site: North Slope #2 Lot: 14 Block: 4 Additional: Parcel #050-581-26-000 Well Depth: Below Ground: Above Ground: 136 ft. From: 134 ft. 0 2 ft 101 113 106 20 113 Level: 101 ft 118 F. 136' of 6" ID Steel 136 Liner Pipe: none Screened: none Perforated: none routed: bentomb Depth: 20'+ evelop. Method: Air se of Well: Residential rilling Method: Rotas) luids Used: none ump Installed: none none To: Formation: 101 existing well 106 wet silty gravel 113 silt, gravel 118 wet silty gravel 136 gravel, silty water 138 silt, little gravel bottom 2 feet filled in to help with silt Pate Drilled: 6-28-2017 Driller: Ben Mattson P.O. BOX 6650 ALA~,K,\ ~-~CHORAGE, 99502-0~.5~0 (907) 264-4111 DEPARTMENT OF HEALTH & HUMAN SERVICES January 10, 1986 TO: Permit Applicant Subject: Permit # 850325 Lot 14 Block 4 North Slope Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If yon have drilled the.well, a well log needs to be sent to this Department for documentation of the installation and to close the permit° If a private engineer inspected the installation of the on-site sewer system the original as-built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit DEPARTMENT' l.' HEAL.]'H AND ENV II:'~ONMENTAL 3"FECT:[ON S25 ]:::' STREET, ANC" ]::~AGE., At< 9950:1. 264..'-4'? ::"..() PERM I T NO: DATE ISSUED APPLICANT: ADDRESS: []OIq"f'AC"f' F'H[]NE '.' 850325 06 / :t 8/85 M I LTON G ~. I~.MORE 732 NORTH BRAGAW ANCHORAGE, AK 99508 2'72-2374 L. EGAL D[L. CRIF . I.. 0 T S I ZIE: MAX BEDROOMS ~. SOBDIVI,SION: NORTH SLOPE SEC'I'ION,~...,~'"r~' TOWNSHIP: 14N 45360 (SQ. FT. OR ACRES) 3 LO]': 14 RANGE: 1E BLOCK: 4 Listed below are the options available to you in designing your septic system. Choose the option that best ¢its your site. .......... ' ............... ......... - '- ;:: g ........ '- ...... DEPTH 'TO F'IPE BOTTOM (FT.) ' GRAVEL DEPTH (Fl'.) 0.5 TOTAl_' DEPTH (FT.) 2.0 GRAVEL WIDTH (FT.) 19,.,() GRA~v'EL. L. ENGTI.4 (F']".) :56.'0 GRAVE[. VOLOME '(CU.YDS.) 25.4 TAIqK.SIZE (GALS)' 1,()00.0 ** SOIL RATING (SQ.F]'./BR) 150 · ~s't.~ DEF"TH 'TO PIPE BO'TTOM < 2.0 FT. RE-QUIRES ADDITIONAL GROUND COVER · ~"~':OEP']"H TO F'II:'E BOTTOM < 3.5 PT. RE[TUIRES INSULA]"ION ~ a.. DEF:']"H 'f'O PIPE BO'T'TOM < 4,,0 FT. MAY REQUIRE A LIFT STAT'I~N · * TANK MUS]' HAVE (~T LEAST ]"WO COMPART'MENTS I certify that: ].. I am ¢ami].iar with the requirement;s for on-site sewers and wells as set. ~or'tl-~ by the Muriicipal:i. ty oF Anchorage (MOA) and the State o~ Alaska. 2. I w:i. ll install 'f. he system in acc:ordance with all MOA codes and regulations, and in coml)liance with the design criteria o~' this permit,, 3. I will adhere to ali. MOA and State o¢ Alabka requirements for ~he set. bacl< dist. ances From any existing well, wastewater disposal system or' public sewerage system on this or any adjacent or nearby lot. 4. I Understand that this permit is valid Cot a maximum o£ 3 bedrooms and any enIargemerr[, will require an acld:i, tional permi't. IF A LIF-T STA'f'ION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THIEN (1) AN ELECT'IRICAL. PERMIT AND INSPECTION MUS]" BE OB'FAINED; (2) AS-BUILT'S WILt_ N[]T BE APPROVED WITHOU'I" AN EI...ECTRI. CAt_ INSPIECTtON REF"GF(T; AND (3) THE ELEC'I'RICAL. WORI< MUST BIS DONE BY A I...ICEIqSED ELECTRICIAN. S I GNED DATIE ." AF:'F'I_ I CANT :: M I L. TG/NI 'G I LMOF-~IE £~,: ..... . .... ,,= ................................. /¢-.) .................................... : ........................... U~ ' "~'~'~ "'~' ~ ...... - ' ' ' (2 - [.,E.h.-F I tIEt'.,!I L3F: I...IIEI::ILTH l:::li'-,![) EZN',,,':[I:.-:'.L-d'.4PIE:NTFtL PF'OTECTIEd",t -'~..' ,_, ~'::": "=._ '"b "' ,'z'~' ...... :"..I::'L': ..... l ..... ::t1"I - I-'I" F'tZl ~1::' !:::1['::: ....... ': ¢: ....... $ -1., ....... :':': ........... ::II'..h'":HFII:~:'I::IG[:' (~;5~4-'-2:].F~:::L ' E :::IFil E F;: :[ ',,,'El:4' C"-'" ~""-~ ......... ~E:.; % qf'," [~Z "~=; F'_:E ~-..,,~ E~:Z ~F-: Il:::" E~ F~: ~'""~ % T' F,..F..I 1 ]:, NC). I' IF F L..~.~..., 1'4 t . 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THE ?¢STEH :IN FiE:_-F:'[C,FIi'.'CE [,.t!TH THE "' _- [:,E::5 FiND HFI',,;'E RECEI'¢E£:, F-! L-.:OP'T' IDF "FH[~;i ":ODE ~;IJI"II"IFtF:"T' F~N[::, I:::,IFIGRFIH F:ITTIqCHHENT2; I.,.IHICH I:~, PRF.:T C~F THIS F'ERH I T. ~:. I UNDEF.:::7, TFtN[::, THFIT THE ON~"-:~;:[TE 5EFJEF:: 5'¢LSTE:!I HFI'¢ Fi:EL.-.!UIP.':E ENLFIF::GEHEI'-4T IF' THE RES I E:,ENCE I ~ I:~:Er,IL-C:,ELEB, TO _T NCLUr_':,E r'ILqRE 'T'HRN PERH I T RF'PL ]; CI:'Ii'-~T I"'IF~:B 'TT'IE RE:SF'Lqi",I:5 :[ D I lC I q"'T' Tm I NF :: Fet',1 PERSOI",!NEL B, UF.: I BIG THE ! N:STF:IL. LFtT I C!N I hE:T,F'ECT :[ ON:~:; OF' RN'-r' ,,..ELL'~' FII:,._TRCENT "FF~ TH 1:5 ~ F'-' ~ F EF..T T FIN[:, THE NIJhIE:ER: OF F.:ES!B, ENE:E:~; 'THFFf' THE FtELL. I.,.I]:LL IF' R LIFT :E'TFITILqi'.,I ]::~ IN:-=;TFILLED., F~N ELEC'TF.:ILqlqL F'ERHIT RNI!:' IN:SF'EC:T]:Oi"~ MU:E;T DE' OE~TFIii",IED. FI:::.~--.'E.;t'LT~5 CFd",!i"4OT 19.:E FIF'F'R"Z',,,'I~"[' !4]:THOLtT FIN ELEL-TPI¢:FIL ]:N:SF%CTION F'EP--RT. THE EL. ECTI:~::I ..'t,_ [,.IC.d:;.:K r,ILtST BE I)ONE E:'T' FI L. ICEi",I6ED EL.ECTF.:ICIFff',I. 'Z-; Z GN El::,: 'F:tI::'F'L.. ]: CFINT: :.':FIL. F'H .:)L":,"¢ Z__ LIED E '¢~~)_ DFITE · :L 2,-."::L 4,.."S 2: Department, f-~&ii%H-REa ~.nvi~6nmenta' ~rotection 825 ~'-~' street, knchorage, AK. ~'9501 264-4720 ~~ * * * HANDWRITTEN PERMIT * * * Permit ~ .~.~/~! ~LL AND/~ON-SITE SEWER PERMIT, Applicant: k~/,-/ /:/~-~/ Mailing Address: Location: Phone Nu~er: ~~'? scr t on: ZX Type of Soil ~sorption System Is: Trench: Drainfield: ~_ Seepage Bed: __Holding Tank: Max~ N~ber of Bedrooms: ~ Soil Rating(sq.ft/br) / T~e Required Size of t~e S¢~l~'-'~orption System Is: . GRAV~TH ~ WIDTH The length dimension is the length(in feet) of the trench or dra~nfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minim~ depth of gravel between the outfall Di~e ana the bottom of the excavation(in feet). * * TANK = ALLONS Pe~it applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the n~ber of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department '~will be subject to prosecution. ~in~ distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minim~ distance from a private well to a private sewer line is 25 feet and to a co--unity sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 I certify that: (1) I ~ f~iliar with the requirements for on-site sewers and wells as set forth by the ~unicipality of ~chorage. (2) I will install the system in accordance with codes. (3) I und~stand th~ the on-site sewer system may require enlargement if %.h~ r~dence/s remoaeled to include more ~hE: ~bedr%m~ ~ ~ / Date: ~/f / ~ · MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST 8 9 11 12 '~.,1 3 --,._~ 14 15- 0 P AT WHAT Z~ ( E IF YES, DEPTH? 17 18 19 No, 1457-~ 20 "~ SOILS LOG PERCOLATION TEST DATE PERFORMED: ~2' ~. (~ E PLAN Gross ' Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE~ (minutes/inch) TEST RUN BETWEEN FT AND ~ FT COMMENTS //tri PERFORMED B~,:~,~ ~R~ ~g~ CERTIFIED~ 72-008 MUNICIPALITY OF ANCHORAGE �i Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-581-26 Legal description NORTH SLOPE #2 B4 L14 Site address 30950 Sagwon Ave Eagle River Current property owner(s) Todd and Kris Jedlicki Expiration Date: L 2 2 3 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date:_ -11-/ �JZ This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory X Arsenic Advisory Other COSA Approvdjune 2022 MUNICIPALITY OF ANCHORAGE Development Services Department - Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-581-26 Complete legal description North Slope #2 Block 4 Lot 14 Location (site address) 30950 Sagwon Ave. Eagle River, AK Current property owner(s) Todd & Kris Jedlicki 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: V Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 6Z Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: © Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 20 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench V Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5-0 Waiver Fee $ Date of Payment I/ A5 Ab a3 COSA # 05C A 3 /011 Date of Payment Waiver # I G 1 7580 COSA Application—June 2022 COSA Checklist Legal Description: North Slope #2 Block 4 Lot 14 Parcel ID: 050-581-26 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA FV_1 Well log is filed with Onsite (or attached) Date drilled 6/28/2017 Total depth 136 ft Cased to 136 ft ❑✓ Sanitary seal is functioning correctly © Wires are properly protected Casing height (above ground) 30 in. Date of flow test for COSA 1/6/23 Static water level at beginning of test 59 ft. Comments B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping 1/18/23 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/23/2002 ✓❑ ALL standpipes present per record drawing Total measured depth from grade 10.75 ft (max) Measured depth to pipe invert from grade 9.60 ft (min) ❑ N/A -- pressurized field. Q Per record drawings, field is insulated. ❑✓ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 5.8+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes R1 Nc ,/❑ Coliform bacteria is Negative Nitrate 0.834 mg/L E]Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by Arcterra Consulting Date 1/3/23 -1/6/23 STATION ❑ Requir—eli-mail t� Age of lift station Lift station material Comments: completed Adequacy test date 1/6/23 Results 0 Pass Fluid depth prior to test 3 in Water added 600 gal New fluid depth 10 in Elapsed time 20 min Final fluid depth 3 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 13.4 in Effective depth used 3 in Effective depth remaining 10.4 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' 0 Yes if No Community Sewer Manhole/Cleanout > 100' Q Yes if No ft ® Yes if No ft Neighboring Tank > 100' n Yes if No ft Private Sewer/Septic Line > 25' QYes if No ft Absorption Field on Lot > 100' 2] Yes if No ft Holding Tank > 100' V Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Q Yes if No ft n Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage? 100' Community Sewer Main > 75' n,, Yes if No ft Q Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Q Yes *if No ft Tank to Property Line > 5' [Z Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑/ Yes if No ft Private Wells > 100' V Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Areterra Consulting Phone (907)-696-61111 Engineer's Printed Name Kenneth Duffus Date 4 L �/Z3 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. u The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The ♦ L(� flow and absorption rates may change due to subsurface conditions that may not be observed from the per.+�"�� CJ surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year o and the water usage of the family being served by the system. The operational life of all well and septic { �F systems are subject to these various and dynamic characteristics and are outside the control of the evaluator or of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen / «.+.+...« encroachments, deficiencies or discrepancies exist. 1 AKENNETH u: U F tc `s GE 7116 COSA Checklist June 2022 Septic Tank Advisory Certificate of On -Site Systems Approval # OSC231011 Subdivision: North Slope #2 Block:4, Lot: 14 The septic tank for this property is 20 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like.