HomeMy WebLinkAboutNORTON PARK #3 BLK 1 LT 7
Craig
Star. Rout~J Box 50 189
)?alrbank~, Alaska 99B01
Subject ~ Permit l~xpiration
Dear ~.~r, Foltz:
A pez~al.t issue(} by this depar'h~%o, nt for w(~l! and/or on-site
sew¢'~r installa~:ion on Lot 7 Block 1 Norton Park Su~livi.~ion
has expired sin<:~e, tile issue date exceeds one (1) year°
In l:he event you still plan to install tho well and/or on~
site ,s~we~: aystem, a new pez2n:[i: is r~tiuired~ '~he original
soil test naif bo used to obtain a ourr~nt per~nit,,
:f;~ the well has been drtll(ad~ a well lo¢~ ahou!(~ be si~nt
to thJ..s dopa:t,-.li~t,,3nt to d.ocum(n'l~ the J.~.stallation ~tateo
'If yo11 have any questions regar(!lnu th~ above ma~ter~ ple~ase
do not hesitate to contaot thi,~ office_~. im~.ediately at 264-
4720,
Robert C~ Pratt
Sanitarian
RCP/ljh
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Parcel I.D. 016-211-71
a
?� n
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION:
Complete legal description Norton Park #3; Block 1, Lot 7
Expiration Dat
Location (site address) 311 W. 123,d Avenue *Anchorage, AK 99515
Current Property owner(s) Thomas & Penny Kottre Day phone 301-9087
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS: 4
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:
COSA to be released to the engineer, unless otherwise requested by the
engineer.
COSA Fee $ 5-5-0
Waiver Fee $
Date of Payment
Date of Payment
Receipt Number
Receipt Number
COSA #
Waiver #
COSA Checklist
Legal Description: Norton Park #3; Block 1, Lot 7
If more than 1 septic system on lot: COSA Checklist #
A. WELL DATA
■❑ Well log is filed with Onsite (or attached)
Date drilled unknown
Total depth *57.4+ ft
Cased to unknown ft
] Sanitary seal is functioning correctly
❑■ Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA $/5/19
Static water level at beginning of test 21.8 ft.
Comments *Per GEG well test
B. TANK DATA
Age of tank(s) - years
Tank type/material
Measured opera
❑ Stand ' /fc
Dsfe--o-f pumping
in septic tank
ndation cleanout per record drawing
D. ABSORPTION FIELD DATA
Which system tested (date installed)
❑ ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
❑ Code -required soil cover over field
❑ System presoaked
(Required if vacant for er than 30 days prior to
date of test)
ped gallons
ncies:
COSA Checklist yellow sheet
of
Parcel ID: 016-211-71
Structure served by this system
Well production at time of test 4.8+ gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes FE N
❑■ Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by GEG
Date of Sample 7/30/19
C. LIFT STATION
❑ Required maintenance completed
Age of lift station yea
Lift stationerial
Commentmat
lFluid
uacy test date
lts []Pass For rooms
depth prior to to in
r adde gal
'depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
a�
DEVELOPMENT SERVICES DEPARTMENT
On -Site water and Wastewater Section
www.muni.org/onsite
Arsenic Advisory
Certificate of On -Site Systems Approval # OSC191379
Subdivision: Norton Park #3, Block, 1 Lot 7
907-343-7904
Fax: 343-7997
A water sample revealed an arsenic concentration of 19.2 micrograms per liter
(ug/L). 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 (www.muni.org/onsite) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
i�lladrn� c�ress,lox9 65 At�chorae gslia 991am
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%A William S. Smith ° �o
No. 4107-S QJ`o o
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p:�9Fo eese°eeoe°° i1
?0FFSSIONA0� ®4P
SPARED FOR M� rM` KOTT2E
ES. BY• Ldp
Y BY
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$✓0010 STb'PS
$3.5 -fit ;
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DATE:3�6�8�� SCALE /'_ 30 � SH. NO. / OF/
W.O. NO FR NO. 03 - B,f GRID.-
AS
R/D.As BUILT
LOT 7/
A/D/270,4/ l/N! T '3
N
ti
ZG16.¢.e FD e 1441- cogs,
107 1/
/ hereby certify that an accurate survey of the
following described property -
Zo7- 7/ (51,! /
,t/OeTO.r/ f/00%l - L WI7- '.3
was made on 41A /S4 and that the
improvements situated thereon are within the
property lines and do not owr/ap or encrooch
on the property lying adjacent thereto, that no
improvements on property lying odpcent• thereto
encroach on the premises in question and that
there ore no roodwnys, transmission lines or other
visible easements on said property except as
indicated hereon.
Dated at Anchorage, Alaska, this E Ih day of
ItUgcll 198 -S
L.S. Na. 4/07-S
GEODETIC TECHNOLOGY
-LAND SURVEYORS -
260/ TURNAGAIN PARKWAY
ANCHORAGE, ALASKA 99503
249-3390
(907) 243-2282
KENJOHNSON
NAME
ADDRESS
LOCATION:
mr(ENIS COMPANY
WATER WELL DRILLING
PUMP SALES-& SERVICE
35 YEARS ALASKA DRILLING
3163 LINDEN DRIVE
ANCHORAGE, ALASKA 99502
DATE 5? 7
PHONE///'/, :31 V%` -
ZIP
A ' / li:.' I. _ 12-1101? ) .11 .
LEGAL: LOT BLK �,s/e,
PUMP DATA HP VOLTS,//, PH AMPS MODEL 5117- 71-4= /-115-61-
CONfROLSs
IN2AKE DEPTH :0 r PIPE SIZEs
TANK SIZE & TY E
FILTERS & TYPE
WELL DAT AI CASING SIZE�/,, DEPTH L. GPM
1)
TIME: ON SIZE OFF SITE '13 r
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BILL SHEFFIELD, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVATION o Telephone: (907)
{ Address:
SOUTHCENTRAL REGIONAL OFFICE
437 "E" STREET, SUITE 200 '
ANCHORAGE, ALASKA 99501 274-2533
May 30, 1984
Arctic Engineers Inc.
1506 W. 36th Avenue
Anchorage, Alaska 99504
Dear Sir:
Subject: Well to Sewer Horizontal Separation Waiver
Lot 7, Block 1, Norton Park Subdivision
The Department has evaluated the subject waiver request and hereby waives
the horizontal separation distance between the private well and the
private sewer service to 18 ft provided that the sewer service line is
constructed of cast iron or ductile iron pipe with sealed joints. The
separation distance between the well and the public sewer is in com-
pliance with 18 AAC 72.021(a).
Sincerely,
ruce E. Erickson
Environmental Engineer
BEE/msm