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HomeMy WebLinkAboutMCCAUGHEY BLK 1 LT 7 LOCATION OF WELL STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELL RECORD BOROUGH SECTION QTRS SECTION TOWNSHIP[~]N I RANGE[] E ids []w MERIDIAN LOCATION/SKETCH: DEPTHS MEASURED FROM:l-lcasing top I-Iground surface 'BOREHOLE'DATA: - Depth Material Type and Color From To WELL OWNER: WELL D~PTH: DATE OF COMPLETION Depth of h-61e:' /O / ..... ft ........... Depth of casing: /0 / ft _~ //4/ / ~:~ DEPT.H_T~O STATIC WATER LEVEL: ft below ~ top of casing li ground surface Date: METHOD OF DRILLING: [~ air rotary [] cable tool [] other USE OF WELL: [~domestic [] irrigation [] monitor [] public supPlY [] other CASING STICK-~P.~.~~'~- ft. Diam: ~' in. to/O/ ft Casing type:. ,~.~c/-~ ~.~ in. to /(;~/ ft WELL INTAKE OPENING TYPE: [~]: open end [] perforated [] open hole Depths of openings: to ft [] screened SCREEN TYPE: ~. Diam: in. Slot/Mesh Size: "' Length:. ft GRAVEL PACK TYPE;~. Volume used: Depth to top: GROUT TYPE: ~ Volume: Depth: from ft to ft DEVELOPMENT METHOD: Duration: /,-~ . PUMPING LEVEL AND YIELD: /~"~ ft after 1~' hrs pumping .~ gpm PUMP INTAKE DEPTH: ft Horsepower: WELL DISINFECTED UPON COMPLETION? ~kYES [] NO CONTRACTOR INFORMATION: , ,A,, Regis~terffd Business Name , Signature of Authorized Resprese'ntative -' Data REMARKS: - PLEASE MAIL WHITE COPY-OF LOG-TO: DNR/DIVlSION OF MINING &WATER MGMT 3601 C St, Suite 800 Anchorage, Ak 99503-5935 Ph(907)762-2538,Fax(907)562-1384 Rick Mystrom. Mayor Mtmicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 15, 1996 Wayne C Britton 6969 Stella Place Anchorage, Alaska 99507 2453 Subject: Lot 7 Block 1 Mc Caughey Subdivision Permit 9SW950156, PID ~014-102-09 The subject permit, issued July 13, 1995 by this office for a single family well and/or on-site wastewater system, has expired as of July 13, 1996. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. SinTely' , P~°gram~a~ger ' ~ j~a ~./ross',/~p.~.j'~/ll On-site Services enc: Copy of Permit PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW950156 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:BRITTON C WAYNE OWNER ADDRESS:6949 STELLA PL 3 ANCHORAGE, AK 99507 DATE ISSUED: 7/13/95 EXPIRATION DATE: 7/13/96 PARCEL ID:01410209 LEGAL DESCRIPTION: MCCAUGHEY BLK 1 LT LOT SIZE: 11537 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM 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 (18AAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5~ THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~/~ /~/'f~ DATE: SET 5/8 REBAR/YELLOW CAP N 90"00'00" E :140.20 ~XlS~ZU~ 5/~ 13.DO ~ 13,00 - · ~ PROPOSEO ,,,/ PAVED DRIVE'[ ~ PROPOSED ~ ' CAN~ / HOUSE L~ ' ' ' , ' ,' ,~ it4 28.00 ~ ~ ,,, , POACH, .{ ~ ) ~ I - eI' I ' ' LOT 6,-' v/'rca/¢~ ~ MUNICIPALITY OF ANCHORAGE WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. PHONE: (907) 564-2762 WASTEWATER CONNECT PERMIT 95-0775 DATE OF APPLICATION 07/12/95 SCHEDULED COMPLETION DATE 12/31/95 BLOCK/LOT/TRACT BLK 1 LT 7 SUBDIVISION MCC~UGHEY ' - SINGLE FAMILY MUTI-DWELLING No. APTS COMMERCIAL TAX CODE 1410209 GRID 0 AS-BUILT STREET ADDRESS 6949 STELLA PL OWNER BRITTON C WAYNE -~. _- MAIL ADDRESS ~,N'CHO~GE,~K 99507-2455 PHONE 907-344-2778 CONTRACTOROwner ASSESSMENTS I Ir-~,- .o,-me"°" Existing Service '--:;:,'";/'.. ~ ' [] Main Line Extension [] On Property Only ........... ~ ~] City Tap .. []~ ToHaVese BeenLeviedLev~ed ~ ~:~'~'~'~'- © TM ~ Main Tap & OnPrope~gC~hne~'-~J}':{'~-- :"-~ : '~ ' ' ~ ........ ~ R&R- Main Tap Only ~': '-'-;-_' I Staff .... .:.. :_ ISSUED BY CAC CONNECT SIZE 4 "' :' : ;: :: .: . .::. INSPECTION FEE $ 104.00 -r:~.-,~_.-' . ' PERMIT FEE $ 35,00 · ~,,... _: :~.,::'~.,....:. pd by visa $ REIMBURSIBLE · , -. ': --::-~-:-' ' NUMBER ' DEPOSIT $ o.oo TOTAL $ REMARKS 139.00 .'[] PAID-.". F'] .CASH [--]CHECK#';:" INSPECTED BY DATE / / PERMITEE (Please Pdnt) wayne sritton MAIL ADDRESS 6838 Stella P1 ~2 ~-~chorage ~ 99507- SIGNATURE PHONE 907-344-2778 POST IN A CONSPICUOUS PLACE AT THE JOB SITE CUSTOMER COPY Odginal PERMIT Is SUBJECT TO THE FOLLOWING CONDITIONS & REGI AT O 1. No sewer main, sewer connection or sewer extension may be covered or back-filled until inspected and approved by an authorized representative of the sewer utility, who shall be notified 2,4 HOURS in advance of when the construction or installation will be ready for inspection, exclusive of Saturday, Sunday and holidays. 2. An application for service must be completed to initiate montly billing. 3. All commercial and industrial structures require the installation of a control manhole for monitoring and sampling purposes. 4. The developer, owner or contractor shall require all permits and pay all fees established by any governmental unit as a condition for the installation of a sewer connection. 5. Permit issuance does not guarantee availability of sewer. It shall be the developer's, owner's, or contractor's responsibility to check elevations of existing sewer mains to insure gravity service is possible. 6. On site sewer systems, cesspools, septic tanks, must be caved in and backfilled prior to connection to the municipality's sanitary sewer system. 7. Permit fee is neither refundable nor transferrable. 8. This permit expires DECEMBER 3fst in the year issued. 9. A 5 plex or larger, or commercial property must have an .engineered set of plans approved by AWWU. These plans shall be asbuilt by the design engineer and submitted to AVWVU prior to acceptance of servIce. 114- 1 - CD rn rn rn r- I,- M m N O Q CL Q U) a) U) 0 4- 0 N _U LO N O N 0 a) (0 C O a_. co .Q X W 0 0 O d) 0 1 N C) 4 CD 0 U CO H W a_ z D 0 Y Q J Z 0 m C O m Q. O 0- D 7 U c O 7 Q N N O O C O � O a) t L — _0 O 0 L O a) Q OL c� L L L ca E o �a a) u c O C �, O � c � U X E O A u Li- 0 m 0 a m Ln LnO N U) O O CC C O N Oo L Q m 0 O 0 c v� U w 0 En.2 ^ C a O < N Q > .tA E y C U 0 U) C O °' L O 3 O CL .N z Q E �-• N r- C. 'a o O m 0O a L a a EN N Q 'a O fq � v .2 '= L d x +�+ N @ }/ O co cC L O `~ U) o N N E'a L o O Q Q O O O _ O to 0 cn � w > 4- O d a)a d L O e ( IL o� Q N a) C s -O c4 v N O v_) Q Q Q` +' Z (n O N O Y O C L Uo o= N CL F- m N Q L Q Q It r— CD 0') O7 0') M M M C? O O rnrn A Ir- C: O Q. U U) (1) 01 a) CL 0 Al cn a) m c 0 CO U O J we 7` 0 m LL L ) ca I I- C: a) ca a o a) > ca E 0 co U a 4t 0 o (a O U o U U_ ) E O =3 () d LO c (D p N U) Q C _E a) 3 O �_ U)_a a N a L O ❑ c V O E _ V L N 7 E NQ 3 U a) ❑ a) N c _0 O c En = a) + > V O ❑ O cn 0) 0 U) y ❑ 3 N a C j..L d_ > C7 nV ✓ L� ❑ L CL L rcu U) 0 ® O p ❑ a) a) cu O ❑ ❑ U +' co °� 0 Q' M W m a) j ❑ N ❑ O O �I > a o U) L � (a O Z_ cn _ a) C/� ��/ (C �. E OW ❑ E]❑ L w ❑< ❑ C ,� E a wW ❑ W (n a) coa U)< Q Z ZO N U) a W u. LL a a) a) 1_ O O U 0 c W W O L a) ai Li a a) c� O H H N Q Q >_ Q� O X �+ N M CF ui to W O m 0 0 m LL L ) ca I I- C: a) ca a o a) > ca E 0 co U a 4t 0 o (a O U o U COSA Checklist WELL ONLY.docx COSA Checklist Legal Description: MCCAUGHEY BLOCK 1, LOT 7 Parcel ID: 014-102-09 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 2/14/1996 Total depth 101 ft Cased to 101 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/10/2024 Static water level at beginning of test 23 ft. Well production at time of test 5+ gpm Water storage tank volume NONE gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic 5.96 ug/L Arsenic less than MRL (ND) Collected by Date 6/10/2024 Comments: Sullivan installed new sanitary seal & conduit. Well located towards middle of southern part of lot near walkway. B. TANK DATA – PUBLIC SEWER Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA - PUBLIC SEWER 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. 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 Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist WELL ONLY.docx 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’ Yes if No NA ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No NA ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ 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’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ 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 FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 6/26/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 6/26/24 ST E L L A P L A C E Taylor L. Dosch No. 189892 R E GISTEREDPROFESSIO N A L L A N D S U R VEYOR