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HomeMy WebLinkAboutPROSPECT HEIGHTS #1 BLK 5 LT 4AOnsite File 1ZA 104, 3 Municipality of Anchorage j 1'' ? "" On -Site Water and Wastewater Program • (907) 343-7904 - Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171253 PID Number: 015-091-30 Dwelling: ❑■ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: PAUL & JUDITH KAPANSKY ABSORPTION FIELD ❑ Deep Trench ❑■ Shallow Trench ❑ Bed ❑ Mound Address 9660 SLALOM DR. ANCHORAGE, AK 99507 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-952-8845 4 1.2 GPD/SF 7.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.0 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision Block Lot PROSPECT HEIGHTS #1 5 4A Fill added above original grade 1.0 Ft. Gravel length 50 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 500 Ft 1 Ft. Well >100' >100' N/A N/A >25' TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORGE TANK Capacity 11250 Gal. Surface Water >100' >100' N/A N/A Material STEEL Number of compartments 2 Lot Line >5' 10' N/A N/A NA Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain None Noted Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer DENALI EXCAVATION Drainfield D3034 CO/MT Inspector JACOB MILLETTE BENCH MARK (Assumed elevation) 100 ft Inspection 15f 9/12/17 9/13/17 Location and description 2nd 3'" 9/13/17 a`" Concrete slab under back deck. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Cin&er's Sta•a. • • u. ap s Conditional Approval: Date tW C'fla r 4.Y'' • �P7 J�1� e; ;� • AV �iT • ,o I IR Approved Date 3 1 Inspection Report_9-1-12.doc ~- `~ � \ / \ / \ � / cu� � rn ` ' \ � �| �_� PROSPECT HEIGHTS NO. 1, BLOCK 5 LOT 4A PERMIT # OSP171253 PID # 015-091-30 2 H 91.5 FINISH GRADE ,/— 90.5 ORIGINAL GRADE \-- NO GROUNDWATER 8/31/17 PROFILE AS -BUILT (NO SCALE) :: ++ BenjaWin Schiller rt��cJ�'•. C912592 PROFESSIONP� MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program ��� .� PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.orgionsite cluu-tmunt 4NCH OPPGE On-Site Wastewater Disposal System Permit Permit Number: OSP171253 Effective Date: 9/5/2017 Work Type: Septic Upgrade Expiration Date: 9/5/2018 Tax Code Number: 01509130000 Site Legal Address: PROSPECT HEIGHTS #1 BLK 5 LT 4A G:2441 Site Mailing Address: 9660 SLALOM DR. Anchorage Owner: KAPANSKY PAUL M &JUDITH Lot Size in Sq Ft: 57935 Design Engineer: ANDERSON ENGINEERING Total Bedrooms: 4 This permit is for the construction of: Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: v Date: /1 ! /7 Issued By: 1 Date: 1757 MUNICIPALITY OF ANCHORAGE `D 1111111111143 Community Development Department � r - 'hlpne: 907-343-7904 Development Services Division AUG 2 4 Zl37 flax: 907-343-7997 On-Site Water& Wastewater Program 3 ti c ON-SITE SEWER/WELL PERM 'APPLICATIO Parcel I.D. 015-091-30 Property owner(s) Paul and Judith Kapansky Day phone Q52-"`3.54r5 Mailing address 9660 Slalom Drive Anchorage, AK 99516 Site address Same Legal description (Sub'd., Block & Lot) Prospect Heights No. 1, Block 5, Lot 4A Legal description (Township, Range & Section) Lot Size 57,935 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank 0 Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage Li 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. -144. 1.1 e Cali-_ (Signature of property owner or authorized agent) PiAsk Permit/Rush Fees: SCA -1'341 11a4-°Waiver Fees: Date of Payment: se1a SI ii Date of Payment: Receipt Number: O8" t°t , Receipt Number: Permit No. 05t'I\ (-2-63 Waiver No. Permit App_9-1-12.doc ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) August 24, 2017 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 4A, Block 5, Prospect Heights Subdivision No. 1 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The septic system on Lot 4A, Block 5, Prospect Heights Subdivision No. 1 has failed and must be replaced prior to the issuance of a COSA. We are therefore requesting a permit be issued for the construction of a new septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the existing well and septic system and the proposed system. None of the existing wells and septic systems on surrounding lots conflict with the new location of the septic system. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test hole recently placed on the lot in the area of the absorption trench and alternate site indicated silty gravel (GM/SM) with sand in the zone specified for the absorption trench. The percolation rate of the soil was determined to be 5.0 minutes per inch. No groundwater was found during the placement of the test hole and none developed during the monitoring period. An application rate of 1.2 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1 ,250-gallon septic tank and a 50' long by 5' wide by 4' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 3' below the surface and the total depth will be 7'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The existing septic tank is located inside the well radius. It will be decommissioned in accordance with Municipal Code. The existing absorption pit is almost entirely in the radius. It will also be abandoned in place and decommissioned in accordance with Municipal Code and all piping connections removed. The ground surface on the lot in the area of the septic system is virtually flat but slopes Lot 4A, Block 5, Prospect Heights Subdivision No. 1 August 24, 2017 Page Two to the west approximately 10' from the edge of the proposed trench. The slope increases the further away from the edge of the proposed trench. The new trench will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and 10' the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, tdtE Michael E. Anderson, P.E. Attachments � 411 • .hS Lv�♦. 10 4p� .. .• /�� �IIaaaii%** <a/ // // rr / / // // LOT 4A, BLOCK 5 --- - -- - / ,/ PROSPECT HEIGHTS NO. 1 - / / SUBDIVISION /• / 58,161 SF / c / / ,;0. / ,o. /A, / <'� <o 449 V e. s Se. 1. S I i / / OF 3) I / Existingis / / ?O/. V� Well �N 4 / / NOTE! \' '. \+ / 1� \\ / Decommission Existing Tank in / / '•° / Accordance with Municipal Code. Q It / \ // // cep,y Crib.weler►Existing Absorption �ie. \11. // - / , 30' Long 4 x 5' Wide x Cp / -- \ - 1►l 4' Effective Depth �' \ / / / e' 6.S.J. Absorption ,1 , i • .•ai 1. •.'' \� / / 1.250 GallonsV# ��. \ / / Septic TaskD % .. .0, / / it \\ / / Existing Crib. �. .") 1 / Location and ,i CO • / 1 Conti�u► tion ! Four ,� .��\r\\t1�1, S�'/ Not Exact. 1 Bedroom if 11 // ���*`� .. 1��♦ ,S3- 11 Home �4 1 / �� �P •' .��8 I rye• - (� y 1 / `, * • I r. Existing tia' // // 49th I\ >% 1 \well / / r, MICHAEL E. ANDERSON •: (o/ \\ !- ---- \\ _ -- _f •-,,, •. NO. CE-4381 '1 / ,.....--\- / 4 / / v0 / SITE PLAN Well Radius \ LEGEND Lot 3 ��\ g / l./ P '� SV - Septic Vent L- C❑ - Clean ❑ut SCALE 1' = 50' A MT - Monitor Tube TH - Test Hole LOT 4A , BLOCK 5 PROSPECT HEIGHTS SUBDIVISION NO. 1 DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5'Wide Trench System Perc. Rate: 1 -5 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 4 Bedroom4 X 150 GPD/1.2 GPD/SF (Application Rate) = 500 SF Absorption Area 500 SF/5 SF/LF'.5 (Red. Factor) = 50 LF Trench Length THEREFORE: Construct a 50' Long x 5'Wide x 4' Effective Depth Aborption Trench at the Location Shown. Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be 7' Below Existing Ground. Provide 3' of Cover Over Trench and 4'Over Tank or Provide 2"of Insulation and 2' of Cover. Maintain 100' Separation From Private Wells in the Area. Natural Backfill 2'6" Geotextile Fabric 6.. - O 4" Perforated - PVC (Holes Down) Drainfield Rock 4'0" 5' I I TYPICAL DEEP TRENCH SECTION �.•••� `��•., (NO SCALE) 4., ............. NOTE: Grade Area Over Trench to Drain Away. 49th /‘ Minimum 6' Separation From Bedrock. • Minimum 4' Separation From Groundwater. • 144-4-1-42 Minimum 100' Separation From Private Wells in the Area. • •fi Michael •E.Anderson c w• ro Minimum 100' Separation From Surface Water or Streams. ♦ C) ; �� • No.CE4381 • Minimum 10' Separation From Water Service Line. ♦sem'•.• • 1� pF •, . am{•7:�4rd. 14, MUNICIPALITY OF ANCHORAGE ��s'o"' 44. 68 DEVELOPMENT SERVICES DEPARTMENT Q'� ..... "4�4.a MP 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 .r G7.• • * '��� wit SOILS LOG - PERCOLATION TEST .:, t. s r 4: ••N • in 1 -"$ LEGAL DESCRIPTION: LOT 4A, BLOCK 5, PROSPECT HEIGHTS SUB No. I 0 'f 6. ; v PERFORMED FOR: PAUL KAPANSKY ,fie,�'•,� �3: �j�.•� DATE: 8/22/2017 PROJECTNo.: 0 '� 00 PARCEL ID#: TECHNICIAN: J. MILLETTE ''"�`�� DI NH I I TEST HOLE 1 11o:0 OB/OG SLOPE SITE PLAN 1 I 4 1 A C .111 4 • a 5 1 " SEE SITE PLAN sa 9 6 A ' a 7 c . •d- POORLY GRADED GRAVEL a. WITH SAND 8 • ' •' a GM/SM 9 10 4 4. WAS GROUND WATER ENCOUNTERED? NONE n IF YES(if WHAT DEPTH') DEPTH OF WATER AFTER MONITORING: NONE r..._________._______ _______ ___.____.._—..--- 1 1 v DATE OF MONITORING: — $/3i/7 ppm/ 12—. n For 81-5 GROSS TIME NET TIME DEPTH TO NET DROP 13 • a s BOH @ 13' DATE READING (MINUTES) (MINUTES) WATER (INCHES) (INCHES) 14— TEST HOLE PRESOAKED PRIOR TO TESTING: 15 8/22 1 5:18 0.00" 16 2 5:48 30 6.00" 6.00" 3 5:49 0.00" 1 4 6:19 30 6.00" 6.00" 18— 5 6:20 0.00" 19— 6 6:50 30 6.00" 6.00" 20 PERCOLATION RATE:5•0 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN: 4.0 FT. and 5.0 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. QGRf-' ER ANCHORAGE AREA BG. 'UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL 70' INSIDE LENGTH MANUFACTURER ~("~t INSIDE WIDTH MATERIAL NUMBER OF / COMPARTMENTS LIQUID DEPTH __ .LIQUID CAPACITY / Z. ~'~) GALLONS. SEEPAGE PIT: /(2~ Z.~ X NUMBER OF PITS / DIAMETER ORWIDT. LENGTH DEPTH ~/';b /4'.~f~ LINING MATERIAL~O~C¢~¢4~; RIB SIZE: DIAMETER DEPTH ~'. DISTANCE FROM: WELL BUILDING FOUNDATION NEAREST LOT LINE Z ¢-~ TOTAL EFFECTIVE -- ABSORPTION AREA (WALL AREA) ~ ~ SQ. FT. ADDITIONAL ABSORPTION WELL: C CONSTRUCTION DEPTH /_/t.~ / DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC '7 /'"2' SEEPAGE /~',-- ' FOUNDATION_ LOT LINE SEWER LINE TANK c..-' SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DIAGRAM OF SYSTEM PIPE MATERIAL:/~// C0.,,¢~ ~r0T) LOT SLOPE: REMARKS: Form No. EQ-031 i- AREA BOROUGH GREATER ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 ! SEWAGE DISPOSAL SYSTEM --- APPLICATION AND PERMIT PERMIT NO. z,¢¢'.-. 2 ?o v NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION ~ INSTALLATION Of: SEPTIC TANK ~ SEEPAGE Pit ~- DRAIN FIELD FINANCED THROUGH TO BE INSTALLED BY PHONE OTHER SOIL TEST RESULTS ~/~E ~/~J ~7' /~/~ ~ /~-F___~ NOTE: THI.~ PERMIT i~ NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANtiCIPATED ~/~//~/~ /q/-/~ 4J~w~ Z~ 7~ / e// FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE '~'7'"~'~-- ~ O/g/~EPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENT~ FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT / SEPTIC TANK TO SEEPAGE PIt WALL SEPTIC TANK - SEEPAGE PIT DRAIN FIELD //0~' / .20/ DRAIN FIELD SEEPAGE PIT / ~ ~ / , ALSO CONSIDER AREA WELLS. SEEPAGE PiT DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD ~SEPTIC TAN~, /¢¢ / SEEPAGE R,T /~ / TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IBON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. G~AVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DIAGRAM OF SYSTEM I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ., / I,~/,,~ ....................... -,,,'R%..O ¢1'~_ ¢.,.~,.~ Performed For Leaal Bescri~tion: This ~orm Re~orts "One test is ~vor~h a thousand opinions" Lot 4flBlock ~ Subdivision ~6rcoi ~tion Test Soils Loq ,m~ Oenth Feet Soil Characteristics I I.- Was Ground Water Encountered? Yes, At what Depth? ,! I' I Reading Date Gross Time Net Time Depth to H20 I Net Dror Percolation Rate Minute Proposed Installation: Seenaoe Pit Drain Field Deoth of....Inl~t ' ' De~th ~ Botto~ Of Pit Or T~rench Test Perfor,led By ~a~O-: Data C'erti~ied By~~~ STATE OF ALASKA 1469 DEPARTMENT OF NATURAL RESOURCES ow,- DIVISION OF MINING, LAND & WATER Alaska Hydrologic Survey WATER WELL LOG Revised 08/18/2016 Drilling Started: / / Completed: 7 / 16 / 1973 Pump Install City/Borough Subdivision Block Lot Property Owner Name & Address PAUL M KAPAN S KY Anchorage PROSPECT HEIGHTS B5 L04A , Well location: Latitude Longitude Meridian S Township 012N Range 003W Section 13 1 NW 1/4 of NE 1/4 of SW 1/4 of NE 1/4 BOREHOLE DATA: (from ground surface) Drilling method: air rotary, nable tool,❑Other Suggest T.M. Hanna's hydrogeologic classification system* Well use:❑Public Supply,❑ Domestic, ❑Reinjection,❑Hydrofracking https://my.ngwa.org/NC Product?id=a 185000000BYub3AAD ❑ Commercial, ❑Observation/Monitoring,❑Test/Exploratory,❑Cooling, ❑ Irrigation/Agriculture, ❑Grounding,❑Recharge/Aquifer Storage, []Heating, []Geothermal Exploration, []Other Fluids used: Depth From To surface organics 0.0 3.0 small to medium gravel: slightly silty to sandy 3.0 57.0 Depth of hole: 425 ft Casing stickup: ft Casing type: Casing thickness: inches Casing diameter: inches Casing depth: ft Liner type: Depth: ft Diameter: inches Note: weathered bedrock: wet 57.0 59.0 bedrock: brown, siltstone argillite 59.0 401.0 bedrock: green 401.0 403.0 bedrock: brown, fractured, small water seeps 403.0 410.0 Well intake opening type: Open end, Open hole,❑Other Screen type: , Screen mesh size: bedrock: brown 410.0 425.0 Screen start: ft, Screen stop: ft, Perforated❑YesONo Perforation description: Perf from: ft, Perf to: ft, Perf from: ft, Perf to: ft Gravel packedOYes ❑No Gravel start: ft , Gravel stop: ft Note: Static water (from top of casing): ft on / / Artesian well ❑ Pumping level & yield: feet after hours at gpm Method of testing: Development method: Duration: Recovery rate: gpm Grout type: Volume Depth: From ft, To ft Include description or sketch of well location (include road names, buildings, etc.): Final pump intake depth: ft Model: Pump size: hp Brand name: Was well disinfected upon completion? Yes LJ No Method of disinfection: Was water quality tested?[]Yes ❑No Water quality parameters tested: Well driller name: WAYNE.E WESTKFR....................................................... Company name: .M:AjDRILLING ............................................................ Mailing address:.PQPPO .110378 ............................................................ N�h City: ANCHORAGE State: AK Zip: 99511 Phone number: ( 907 ) 945 - 3287 AS 41.08.020(b)(4) and AAC 11 AAC 93.140(a) require that a copy of the well log be submitted to the Department of Natural Driller's signature: Resources within 45 days of well completion. Well logs may be submitted using the online well log reporting system available at: Date: Anchorage Municipal Code 15.55.060(1) and North Pole Ordinance 13.32.030(D) require that a copy of this well log be submitted to the Development Services Department/City https://dnr.alaska.gov/welts/ within 30 days of well completion. OR email electronic well logs to City Permit Number: Date of Issue: dnr.water.reports(cDalaska.gov Parcel Identification Number: 'Guide for Using the Hydrogeologic Classification System for Logging Water Well Boreholes by Thomas M. Hanna NGWA Press 4CHORAGE, ALASKA 99509 DRILLING LOG ` Well Owner 'sul YE oan ck}Use of Well Dom Location (address of: Township, Range, Section, if known; or distance main road LI:A, Bik-- Prosoect Ets. Size of casing Depth of Hole X25 feet Cased to 60 feet Static water level t. (above) (below) land surface. Finish of well (check one) open end ( X ) ; Screen ( ); Perforated ( X ). Describe screen or perforation ''-i lls Ynif'e S1ots (,Zf t. ) t 50-150 ft., death level Well .pumping test at 2 gallons per (dour) (minute) for—j--hours with 1005 ft. of drawdown from static level. Date of completion 15 July 7 . WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness C TO 3 Surface Brcrenics Z TO S 5ma►11 to t:edi Vravel t elirhtly silty to eandy • �.r` .7 TO ,9 ++ea tt,ered Bedrocri t wet t `9 TO 1+01 bedrock: Brown, siltstone areillitc 1�v,TO Greer. t , L07OJ4 lQ " Brown. ;'ractured, am -all :rater seipe f;l�'O 425 Brown TO TO CJW'' S W )44f P4 E T � N TO f/ TOTO r -y 'e E.. aonLLorgJ TO TO 1 TO N 3 — Contractm L*i STATE OF ALASKA 1217 DEPARTMENT OF NATURAL RESOURCES ow,- DIVISION OF MINING, LAND & WATER Alaska Hydrologic Survey WATER WELL LOG Revised 08/18/2016 Drilling Started: / / Completed: 8 / 5 / 1978 Pump Install City/Borough Subdivision Block Lot Property Owner Name & Address PAUL KAPAN S KY Anchorage PROSPECT HEIGHTS B5 L04A , Well location: Latitude Longitude Meridian S Township 012N Range 003W Section 13 1 SW 1/4 of SE 1/4 of NW 1/4 of NE 1/4 BOREHOLE DATA: (from ground surface) Drilling method: it rotary, nable tool,❑Other Suggest T.M. Hanna's hydrogeologic classification system* Well use:❑Public Supply,❑ Domestic, ❑Reinjection,❑Hydrofracking https://my.ngwa.org/NC Product?id=a 185000000BYub3AAD ❑ Commercial, ❑Observation/Monitoring,❑Test/Exploratory,❑Cooling, ❑ Irrigation/Agriculture, ❑Grounding,❑Recharge/Aquifer Storage, []Heating, []Geothermal Exploration, []Other Fluids used: Depth From To stick-up 0.0 2.0 organics 2.0 3.0 Depth of hole: 608 ft Casing stickup: ft Casing type: Casing thickness: inches Casing diameter: inches Casing depth: ft Liner type: Depth: ft Diameter: inches Note: silty gravel 3.0 36.0 silty sandy gravel 36.0 46.0 silty clayey gravel 46.0 56.0 damp silty gravel 56.0 58.0 Well intake opening type: Open end, Open hole,❑Other Screen type: , Screen mesh size: Screen start: ft, Screen stop: ft, Perforated❑Yes 0 No wet gravel 58.0 160.0 bedrock: small water seeps in sporadic fractures 60.0 610.0 Perforation description: Perf from: ft, Perf to: ft, Perf from: ft, Perf to: ft Gravel packedOYes ❑No Gravel start: ft , Gravel stop: ft Note: Static water (from top of casing): ft on / / Artesian well ❑ Pumping level & yield: feet after hours at gpm Method of testing: Development method: Duration: Recovery rate: gpm Grout type: Volume Depth: From ft, To ft Include description or sketch of well location (include road names, buildings, etc.): Final pump intake depth: ft Model: Pump size: hp Brand name: Was well disinfected upon completion? Yes LJ No Method of disinfection: Was water quality tested?[]Yes ❑No Water quality parameters tested: Well driller name: WAYNE.E WESTKFR....................................................... Company name:.M:AjDRILLING............................................................ Mailing address:.PQPPO .110378 ............................................................ N�h City: ANCHORAGE State: AK Zip: 99511 Phone number: ( 907 ) 945 - 3287 AS 41.08.020(b)(4) and AAC 11 AAC 93.140(a) require that a copy of the well log be submitted to the Department of Natural Driller's signature: Resources within 45 days of well completion. Well logs may be submitted using the online well log reporting system available at: Date: Anchorage Municipal Code 15.55.060(1) and North Pole Ordinance 13.32.030(D) require that a copy of this well log be submitted to the Development Services Department/City https://dnr.alaska.gov/welts/ within 30 days of well completion. OR email electronic well logs to City Permit Number: Date of Issue: dnr.water.reports(cDalaska.gov Parcel Identification Number: 'Guide for Using the Hydrogeologic Classification System for Logging Water Well Boreholes by Thomas M. Hanna NGWA Press raCL<G�,l NC. DRILLING LOG Well Owner Paul Kapansky Use of Well Dom. Location (address of: Township, Range, Section, if known; or distance main road Lot 4A Block 5 Prospect Heipzhts Anchorage Size of casing 6" nepth of Hole 610 feet Cased to 61.6 feet Static water level 69' ft. (x}0.ve) (below) land surface. Finish of well (check one) open end (xx ); Screen ( ) ; Perforated ( } . Describe screen or perforation N/A Well pumping test at—_.-5—gallons per (loam) (minute) for hours with i nn J lit of drawdown from static level. Date of completion 815/78 WELL LOG' Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 2 2 TO 3 3 TO- 36 36 TOS_ _T0 55. 5 55.5TO-_28- 58 O5858 TO 60 60 TO_6 10 TO TO TO TO TO TO TO Casing stickup Organics Silty sandy gravPi Siltyrl aypv gravel Damp silty gravel '' q Wet gravel ,���s �.i i) ,Y4SZ' .:�hyl F! i'a. :yam � . Bedrock• small water SPPI)Q i- spa Adir frArt-iiras UIN Nt1NVA C(-:tified Con't"etot Certificate o s.. f a ' L w i W 6� W ,<1 -CUSTOMER s 6189 1077 • • �•4j4ri A ref Q& Municipality of Anchor: ° On-Site Water and Wastewater Prog AUG 0 8 2018 Liii FL(907) 343-7904 E T Y ti t6 Certificate of On-Site Systems Ap• • 11 6 9 g"� Parcel I.D. 015-091-30 Expiration Date: JF 1. GENERAL INFORMATION Complete legal description Prospect Heights No. 1 Block 5 Lot '4A Location (site address) 9660 Slalom Dr. Current Property owner(s) Paul & Judith Kapansky Day phone 907-952-8845 Mailing address 9660 Slalom Dr. Anchorage, AK 99507 Real Estate Agent Day phone 2. TYPE OF DWELLING: Q Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual Individual Water Storage ❑ Holding Tank ❑ Community Class_ Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: V.X/LgnLtlit✓ r Date: 0/11/0 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 0,(.0 Waiver Fee $_- Date of Payment BR � Date of Payment Receipt Number /� 0 3633 D Receipt Number V COSA# 5 C1SNto 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 Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave. Suite 203 Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 8/6/18 OFA , j*. 49 TH %I\ *+�� 6. DSD SIGNATURE System#1 Approved for ( bedrooms SFA �. Michael E.Anderson' jY ' System#2 Approved for bedrooms t♦,F••• 381 *.",',k-411-'' it lF�F� O�'.� Disapproved �1��PROFESSI\\".�� Conditional approval for bedrooms, with the following stipulations: v\ •� CA ON_ST I �L E SAS ER AND zc vvAT PROGRAM R • By: / Original Certificate Date: 5?-1 S j 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 Advisory . Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r .. c 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: Prospect Heights No. 1 Block 5 Lot 4A Parcel ID: 015-091-30 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 6/7/73 : 8/5/78 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 425/610 ft. Cased to 60/61.6 ft. Casing height(above ground) 12 / 20 .n. FROM WELL LOG AT INSPECTION Date of test 6/7/73 : 8/5/78 8-02-17 / 8-31-17 Static water level 55 : 69 ft 70 / 59.3 ft. Well production 2 : 0.5 gpm 2.6 / 1 .25 g p m WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 2.85 mg/L Arsenic NDug/L Date of sample: 7/31/18 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 9/12/17 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping Pumper New Tank C. ABSORPTION FIELD DATA Date installed 9/13/17 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type 5 wide Length 50 ft. Width 5 ft. Gravel below pipe 4.05 ft Total depth 8 ft. Eff. absorption area 500 ft2 Monitoring tube Y Depression over field N Date of adequacy test New 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 >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) A( 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 >100' On adjacent lots >100' Absorption field on lot >100' 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' 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 >101 Surface water >100' Driveway, parking/vehicle storage >10' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS *Well #2 depth taken from old inspection report. No well log on file. **There are 2 wells on lot. (well #1/ well #2) G. ENGINEER'S CERTIFICATION ��OF A�Nq k Ai.I certify that 1 have determined through field inspections and �,`Q.,. .S',r l+ review of Municipal records that the above systems are in Cry . �� •...*0,9 conformance with MOA COSA guidelines in effect on this date. 0*.•49 TH /\ ^ ••*0r/ Engineer's Printed Name Michael E. Anderson, PE giii,,, ,t EG �jDate 8/6/18 r . Michael E.Anderson .� e rKis.• 4381-E ...�`, Sic%sl;�•.jj.i..f•/5;•,c ,:� �l ��PROFESSION' l��\\\tri COSA brown sheet 10-10-12.doc Frontier Surveys, LLC Project No: 17-315 Date: October 20th, 2017 NORTH Ordered By:Chris Swires PIat:72-215 Grid:N/A Scale 1"=60' / / / / / / / oo / LOT 48 4) / PLAT NO.72-215 Ki WW2 C~ kP / 4i /o• / jso,, 3, Prospect Heights#1 ?0I / Lot 4A,Block 5 58,196 sq.ft.+/- 9660 Slalom Drive 3 Story Wood Framed House ©® / w/Attached 2 Car Garage / 2ND STORY DECK/1ST FLOOR STORAGE / /1' ® 4)/,/ ' I, `---,\ \VEIL X82 ASPHALT PATH C cs �j 23.3' © / %%I 3p •. / s8^I A„i fr 8.0'\J q, I ������ ^� \ ,..<0. / CONCRETE WAI\ / N' 17.2' ELI•PRINARV/I y 6.2' ,> / / 7.9' 2.3' o j / / / LOT 3 / PLAT NO.67-23 /i'. / J4' GRAVEL --1�', / / ,F0.4) / (. / 7 Legend: ,/ n Electric Meter/Outside Power / OI Gas Meter ;moi Deck 0 30 60 120 OSeptic 0 Water Well iiiiil Feet General Notes: 1.This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law. 2.Excepting for gross negligence,the liability for this survey shall not exceed the cost of preparing this survey. 3.All measurements/setbacks are to the visual/apparent building footprint. 4.Dimensions to property lines are plus/minus 0.1ft. \`x%•••"\11111 This survey complies with ASPLS Mortgage Location Standards.The survey represents visible improvements and t lO F 4111111 conditions at the time of the survey.This document does not constitute a boundary survey and is subject to any '� • ., 4 )1 inaccuracies that a subsequent boundary survey may reveal.It is the responsibility of the Owner to determine _�.c Q'• • • `s' 1// the existence of any easements,covenants,or restrictions which do not appear on the record plat.Under no G) '' •'. 9 // circumstances should this document be used for construction or for establishing a boundary or fence line. *: 49TH/\ * i As-Built Survey of: '7• _ i Lot 4A Block 5, Prospect Heights #1 A FREDERICK W.IWISIER : ¢ I,Frederic Wagner,hereby certify that this Mortgage Inspection Survey was performed by me,or //�Ci •• • NO.L.S.•9946 4+- under mydirect supervision on May16th,2017. ///`rA e. •. 10/23/2017 • p o �,P�= Frontier Surveys, LLC FRONTIER* /1I l t���,;;"ONA;`.� 650 W.58th Ave.Suite E Anchorage,Alaska 99518 t I , t 907.460.1686-info@frontiersurveys.com .► . • PROFESSIONAL SEAL www.frontiersurveys.com P 6.