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Certified Drilling Log
DOC CO dba
BILL 8& COLE
ULLIVAN WATER WELLS
eftP.O. Box 670269, Chugiak, AK 99567 688-2759
OWNER OF LAND: Chuck Smithson
ADDRESS:
LEGAL DESCRIPTION T15N R1W Sec 9 Lot 84
DATE: 7-24-18
PERMIT NUMBER: OSP181083 DATE OF ISSUE: 5-23-18
TAX IDENTIFICATION NUMBER 05110411000
Is well located at approved permit location: ®Yes ❑No
Method of Drilling: ®air rotary ❑cable tool
Depth of Well: 65'
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 65 feet
Liner type
Static Water Level: 30 feet
Recovery Rate 15 ® gpm ❑ gph
Method of Testing Air
Well Intake Opening Type: ® open end ❑open hole
❑ Screened Start feet Stopped
❑ Perforations Start feet Stopped
Grout Type: Bentonite Volume: 6 bags
Depth: from 2 feet, to ? feet
Well Disinfected Upon Completion: ®yes ❑ no
Method of Disinfection: Chlorine 50 PPM
Comments:
WATER QUALITY TESTING
Coliform m
Mtretes 6.a3—
Arserdc AID tag 17 �
Bore Hole Data
Depth
From To
0 2
2 3
3 4
4 5
5 9
9 39
39 42
42 61
61 65
Casing Stickup
Overburden
Boulder
Silty Sand & Gravel
Boulder
Silty Sand & Gravel w/ Boulders
Silty Sand & Gravel Wet
Silty Sand & Gravel w/ Clay
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.
DOC CO dba
BILL a. GALE
ULLIVAN WATER WELLS
P.O. Box 670269, Chugiak, AK 99567 688-2759
www.suilivanwaterwells.com
Pump Installati®n Log
Well Drilling Permit Number: SW OSP181083 Date of Issue 5-23-18
Parcel Identification Number: 05110411000
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
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.org/onsite
On -Site Water System Permit
Permit Number: OSP181083
Work Type: Well Upgrade
Tax Code Number: 05110411000
Site Legal Address: T15N R1 W SEC 9 LT 84 G:1358
Site Mailing Address: 22231 AURORA BOREALIS RD, Chugiak
Owner: SMITHSON CHARLES W & HEIDI M
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
C17t
i
1)eluirtment
5/23/2018
5/23/2019
2 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
Special Provisions:
To close out this permit, please submit the following to MOA On-site:
1) Well log
2) Pump installation log
3) Water sample results for total coliform, nitrates and arsenic. — > 5 - U yyt /
S Yom! I cl cQd W/ H D P E a v`
Lki-s , aA f h e (N rA d u s. P -M C
Received By Date:
Issued By: Date: Jt- .2 3 1
0
Ji
Municipality of Anchorage
P.O. Box 196650 0 4700 Elmore Road
Anchorage. Alaska 99519-6650 0(907) 343-7904 0 Fax (907) 343-7997
hfti2://www.muni.org/Onsite
Develo oment I
is
Serves 2D2poartment g tmen
On -Site Water and Wastewater Section
V,
Mille
N,
Waiver#: OSV181038 COSA#: Permit#: OSPI81083
PID#: 051-104-11
Legal Description: T1 5N R1 W Section 9 Lot 84
Engineer: Garness Engineering Group
Applicant: Charles Smithson
Your request for a waiver of the required 100 feet horizontal separation from the existing
septic tank and absorption field to the private well has been approved. The approved separation
distance is 80.0 feet. See engineer's waiver request letter for justifications for granting this
waiver. In addition, the population density is very low in this area.
This waiver approval applies to the existing septic tank and absorption field only. Any future
upgrade to the on-site wastewater disposal system will require all separation distances be met or
another approval from this department.
H 0 a M a a as 2 a Z a 2 a M 2 2 M a H M 0 M a a X a a It a as a a 0 a 8 8 a a 8 0 M H 3 a ff a a a a a M a® 0 H 0 is Is a® a a a a M a M a a N M a s® 2 21
Waiver is Granted: X Waiver is not Granted:
Date: ru_i/ C,11 qj is Approved by: �0,
Name of Reviewer
a 0 a N 0 11 2 M M a H 2 a M a a a a 0 a a a 0 a a a B a a 0 a M H M Z a Z 2 a a a a a 0 a a 9 IX a a a M a 2 M M M 2 of a a a Is X in a a a a M III a a a I
J -p
An
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MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
On -Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 051-104-11
Property owner(s) CHARLES SMITHSON
Day phone 907-343-3883
Mailing address 22221 AURORA BOREALIS *CHUGIAK, AK 99567
Site address 22221 AURORA BOREALIS "CHUGIAK, AK 99567
Legal description (Sub'd, Block & Lot) T1 5N R1 W SECTION 9 LOT 84
Legal description (Township, Section & Range) T15N R1 W SECTION 9 LOT 84
Lot Size
APPLICATION IS FOR:
( ® all that apply)
Absorption Field
❑
Septic Tank
❑
Holding Tank
❑
Privy
❑
Private Well
Water Storage
❑
Sq.Ft. Number of Bedrooms 4
APPLICATION IS AN:
Initial ❑
Upgrade
Renewal ❑
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
TYPE OF DEWELLING:
Single Family (SF) ❑
(w/wo ADU)
Duplex (D) ❑
Multiple Dwellings ❑
(SF and/or D)
'WA WEA\ -fro Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees: ./s Waiver Fees: 2
Date of Payment: 519112 Date of Payment:
Receipt Number: GO165
6 Receipt Number: 0 0
Permit No. W PI91683 Waiver No. D S V 18& M �8
(Rev. 01 /11)
Co `w 1
0-lanic's
rammynyaws ,
GARNESS ENGINEERING GROUP Ltd Adv-_tmcntSyr_tcm
� ems,
ENGINEERING SALES -CONSULTING
June 26, 2018
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Well Permit Request for T1 5N R1W Section 9 Lot 84
To whom it may concern:
0SVI&1058'
112
The existing lot is served by a private well on the lot to the north (T15N R1W Sec 9 Lot 73). Per
conversations with the owner (Charles Smithson), the easement granting well/water access is void and a
new well must be drilled on property. The existing well on the north lot currently serves two separate
trailers on the subject property (see attached 40 scale). There is a 50' BLM easement to the north and
south of the property line. In short, the proposed well location should be 100' from the septic system for
the lot to the north. In addition, per conversations with the owner of the lot to the north (Randy McCain
229-6009), the septic system for his property is located north of the house. Prior to drilling the well, this
will be physically confirmed by the well driller. As can be seen on the attached 40 scale, the proposed
well location is 80 feet from the existing septic tank. It is our understanding that there is a "powerline" at
the road and the well needs to be east of the road to allow enough room for equipment to operate. We
are requesting that your department issue a variance from the required separation distance of 100 feet
from well to septic tank and drainfield down to 80 feet. Justification for granting this waiver are as follows:
• Moving the well to a location of 100'+ from the septic tank and drainfield would be significantly
more expensive.
• The septic tank and drainfield is approximately 37 years old (installed in 1981). When the septic
system is upgrade, it is our recommendation that the tank be moved outside the 100 -foot radius.
• The driveway is located between the tank and proposed well. If effluent were to overflow, it would
be noted by the homeowner and corrective action taken.
• Request that a special provision be stipulated that water samples be pulled after the well is
drilled. If the water samples indicate elevated nitrates (above 5.0 gm/L), the tank will be replaced
with a plastic tank or a new tank will be installed outside of the well radius.
• The drainfield is located under the southern trailer and the driveway is located between the well
and septic tank/drainfield. If effluent were to overflow it would be easily recognize by the
homeowner and corrective action taken.
• Per MOA records, the drainfield is an additional 5' from the tank. It is plausible the drainfield is 85'
from the proposed well location.
We are unaware of any adverse impacts this installation and/or waivers would have on adjacent wells or
septic systems. Ifou have any questions, please contact us at 337-6179. Thank you for your
assistance.
ly,
Jeffrey #. ** els, P.E.\M.S.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
#A
PRIOR TO DRILLING THE WELL; WELL DRILLER Tl 5 N R 1 W SECTION 9 LOT 73
CONFIRM LOCATION OF SEPTIC SYSTEM TO THEE
NORTH WITH OWNER RANDY MCCAIN
EXISTING WELL TO BE DECOMMISSIONED PER UPC. WATER LINE AT PITLESS
TO BE CAPPED TO ENSURE NO BACK-FLOW FROM EXISTING WATER LINE
INTO THE WELL. IF THE OWNER OF THE WELL ON LOT 73 WISHES TO HAVE
THE WELL CONVERTED TO AN AGRICULTURAL WELL, HE WILL NEED TO tN
CONTACT THE MOA ONSITE DEPARTMENT AND MEET THEIR REQUIREMENTS.
V.
50' BLM Road Reservation \ \
\ \
10' GAS EASEMENT NT
TENT
------------ft J t--------------
PHONE NUMBER:
1------- — ---- — ----------------
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907-343-3883
2 OF 2
PROJECT/LEGAL DESCRIPTION:
DRAWN BY:
T15N R1 W SECTION 9 LOT 84
LU
W I
D.J.G.
50' BLM R�d Reservatign `��
DRIVEWAY
\` i W
�,_ SEPTIC SYSTEM DESIGN UPGRADE
6/21/2018
If
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--- �r----- --------------
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TENT
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GRAVEL /
' DRIVEWAY '
'------- I
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APPROXIMATE LOCATION OF
SEPTIC TANK PER CLEANOUT
LOCATIONS AND SURVEY
PROVIDED BY FRED WALATKA, PLS
APPROXIMATIS\LOCATION a' ROAD EASEMENT
I PER MOA ONSITE MAPPING P VIDED TO GEG
j
`�� /
BY THE MOA ONSITE DEPA ENT�O
/ /
'Py
q
/ /
09�c
ASSUMED DRAINFIELD LOCATION
/
BASED UPON MOA RECORDS AND
a
`�
SUMP NOT SHOWN ON SURVEY
NOTE: THE CONTRACTOR SHALL HAVE THE
BLM ROAD RESERVATION EASEMENT AS
WELL AS THE BOREALIS ROAD EASEMENT
FLAGGED BY A REGISTERED LAND
�`.� ` •
�`�`
SURVEYOR PRIOR TO CONSTRUCTION.
AFrAr Ag
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS --
3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907) 337-6179 • FAX (907) 338-3246' WEBSITE. w .gamessengineering.00m
PREPARED FOR:
PHONE NUMBER:
PAGE NUMBER:
CHARLES SMITHSON
907-343-3883
2 OF 2
PROJECT/LEGAL DESCRIPTION:
DRAWN BY:
T15N R1 W SECTION 9 LOT 84
D.J.G.
TYPE OF WORK:
DATE:
�,_ SEPTIC SYSTEM DESIGN UPGRADE
6/21/2018
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Detail A Detail B
Scale: 1" = 30 Scale: 1"=30'
I121.5 Well
LOT 73
\\ \ T N89°59'00"E 330.26 Wire fence(typ)
\ \a /, / _.' i /
01 10'Gas Easement\ _ (Book 1010,Pg 10 —��' rw �: I Coop
N �\ `: coop � coop A I I
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ent -20'x 80'M EA Easement
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\L�.'Y ?F yy LOT 83
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o 75 — -
N89°58'08"E 268.71 (Computed)
1 LOT 97A
1 Note: Bearings computed from data per BLM Survey dated May,13,1955.
AS-BUILT NO CORNERS SET THIS DATE
I OF I hereby certify that I have performed a Mortgagee's inspection
Q�� A�A'‘F/T-1l oT15N.following
R W Scribeproperty:
.M.. ( � LOT 84,SECTION 9,
��•• ��A1
I 00*' 49th vlT * i Anchorage Recording District,Alaska.and that the
,y !!!��^VVI •/ mprovwnents situated thereon are within the property lines
�4 ••• % and do not overlap or encroach on the property tying
1 elf adjacent thereto,that no improvements on the properly lying
/ c•.Fred Wa l o tka:If- adjacent thereto encroach on the premises in question and
•• 3255-S R•� that there are no roadways,transmission lines or other
••r,•_ visible easements on said property except as indicated
SCALE: 1"=40' ,,,II°.°T•SSiC00.• J1" hereon.
Dated at Anwar Alaska
EASEMENTS OF RECORD,OTHER THAN ' t%.%••% ' this 5th age day of January ,2018.
THOSE SHOWN ON THE RECORDED FRED WALATKA 8 ASSOCIATES,L.L.C.
PLAT ARE NOT SHOWN HEREON FB 17-11, pg 63 BE 907-248-1666 Engineers and Surveyors
UNLESS OTHERWISE NOTED.
It
MOA Onsite Map
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AWWU SAS GIS
Sources:Esri,FERE.Gamin,Intermap,increment P Corp..GEBCO.USGS,
MOA Onsite Map
Geographic Society.rated I MOA GDIC,Parks and Recreation I MOA GDIC.Parks and Recreation I GDIC,MNO(GDIC.MOA MNO I GDIC,MOA I uantun Spatial I MOA,GDIC i MOA.USGS,Merrick Jamie Young I AWWU SAS GIS I Lad Records,GDIC I GDIC,Lard Records
%~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
'~- ~ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
[] UPGRADE
.EOAL.ESCR,.T,ON
LOCATION NO. OF BEDROOMS~
~ ~ Manufac~er
Li~ gallons IF NOMEMADE: Inside length Width Liquid depth
, ~ Well Dwelling PERMIT NO.
~Z DISTANCE TO:
--'~ Length~l_i.~e, ¢ Total ~ of lil~ T~l~idth inches Distance~etwee '1' e
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diame Crib depth Total effective absorption area
aa Cla~¢t.~ .( ~/~--Depth Driller Distance to ~ot line PERMIT NO.
~ Bu~]d]ng foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
SOl L TEST RATI
INSTALLER
(Rev. 3/78)
F'ERMIT NO,
I::IF'F'L I CFINT
L. OCFI"f' ~ ON
LEGRL.
[)EPRRTMENT O, HERLTH FIND ENVIRONMENTRI-, t JTEC'f'ION
825 "L'" S'rREET., RNC;HORRGE., RI<:.
,:: S&O50::L )
.HRRL. E:;:, S,M I THSON
NORTH E:I R ] HI4C,3B, LOOF'
.. ' ~ LOT .~,4
$Ef': '=,~ r::t,. N RiW ':'
_,1 HR RTE
LOT ::,
"rYF::'EE OF =,JZL.. i.~E...,JF,.FTIOI',I =,~.-FEi'l
, , 'DF: E:EDRiDC'Id$ = / ¢
MR,':,ZH, fl i'.,tUf'IBER
'THE RED174UIF. tED .::,I~..E OF THE ::,~lL RBSORF'TION -~t..'.'fEfl IS:
-:. -- ...... - ......-.~ "'~ R F"~ %"" E L
[Z:" E-"?.:' F" -!- ~"'"~ == -~.:. IL... [-%' !"-.i ,...~ T I !1 ......
208000 '='2J::IRE FE:ET
1 F. EN
SOIL RRT I I",IG
El.) E P -r I,-I ==::
· .'.':' · l::, THE LENGTH ,.:IN FEET) OF THE TRENC:H FiR E:,RRINFIE:LD.
THE: LENGTH [.IMEN-,]ON ' ' .....
": ,:" ..... ::' OF' THE
THE [.EFTH t]F R TRENC:H OF.'. PIT :Ih-; THE E.,Iz, TRNL. E BETI4EEN THE =,IJRFF'ILE
GF).OLIND FINE:, THE BOTTOM OF THE E';,<,CF]VF-ITION (TN FEET).
,-' ,-- FCF.' TREN .::1
THERE ]=, NO _,ET WIDTH
THE GF.'.FI',,,'EL DEPTH Ir; THE M~NIHUM DEF'TH OF GRF:IVEL BETNEEN THE OUTFF:IL.L. F'IF'E
FIN[) THE E:OTTOi"I OF 'THE E::.,',CR',,,'FITZON ,::II",l F'EET). /
J;~: E II:~ LI :[ [;~ E [:" ..=. E t'-" T I C:
, p..,-' ",'" RE'.L-qPONSIE~ILIT"r' TO INFORId THIL; DEPRRTMEF,IT DUF.'.'.[NG THE
F'ERMIT RPFLI..RM[ F,Itqx, THE 1HI. FF.LFEF..IT FIf.,l[b THE
INSTFILLRTION IN',~,PECTIONS OF
NUMBEF.'. OF RESIDENCES THRT THE NELL 1,4ILL .... ER. E.
..................... T~.,..IIO ":.. ,=..
BR_.,kF~LI..iNG OF RN"r' z,'r_,TEM 1.4ITHOUT F~f',IRL 'rN"5, F'ECTION RN[:' RF'PROVRL BY I FIZ ....
DEF'RRTHENT 14ILL BE ~JB.TEC:T TO PROSECUTION.
':'.;~ "~- "' ' I .::~
MINIMUM B,I_TRNL. E RETktEEN FI WELL RND RN¥ (IN-SITE SE!.,.IF.IGE DI~F'OSRL z'r_ I EM
FUE, L1L. kIEL J_ DEF'ENDING
:1.00 FEET FOR FI F'F.:IVRTE I.,.IEL. L LF; 'tf"~F~ TO 2¢.48 FEET F'Rf]M R
UPON TFIE TYPE OF F .BL~L. I.,.1E'.LL
i'qINZMIJH DIC;TRNCE FF.JM R F'RIVRTE 14ELL TO FI F'RIVRTE .TEHEF.. LINE L:, ;'2'.5 FEET FIN[)
TO FI COHMt..INIT"r' SEI.,.IIE3~'. LINE. TE; 75 FEET.
OTHEiR REI;!UZRE]"IENTE, MR¥ RPF'LY. '.'SPEC:IF~CRTIONL~ RND CONLE, TRUCTION DZRGRRi'dL:'i RRE
RVRZLRBLE TO TNSURE F'ROPER INSTRLLRTIOI',t.
~:~.. E
F"E;F:r"I :E 'f" E.,-'-.F ]: '-' ""=' [',E~-:EI'"IE:EF: ..:=.dr ..... :.L ........ .?..L
I CERTZF:"r' THRT '],, "' ' ':; ', 'B'" HELLS Pa,.".'q SET
'1: ;I; Ri"1 FF'IMILIRR !.,IITH THE RE6!UIF.'.EMENTS FLR Of.,I-=,ITE _E!-.IE..J FIND
FOR"tH E"r' THE MIJNZ_.IFRLI] OF FINCHORRGE.
¢. ,,-' HL:L. URE.,RNE. E NI'T'H THE _.uDE_,.
2: I klILL 1N.::,FRLL THE _3r=,TEM IN - "'"" ' T
- -i -'q., ' '- - ,'~,,""" REQUIRE ENL. RF..LiEMEN IF' THE
<: I UN[:,ERSTFtND THRT THE LN-=I'fE =,EI4E. R =,~.z, rEM MR'T'
., ] ',- " INCLUDE i',IORE THRN "4: BEDROI3HS.
RESI[)ENCE IS F, EM~BELED TO
RPPL I CFINT bFIRRLES; S~TI-ISON
I SSI.IED B"r'..~~-~ ..............................................
PERFORMED FOR:
2
3
LEGAL DESCRIPTION:
9
10
11
12
13-
14-
15
16
17
18
19-
20-
COMMENTS
MUNICIPALITY OF ANCHORAGE<~~//' '
[]
SOILS
LOG
[] PERCOLATION
DEPARTIVIENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SITE
PERFORMED BY:
72-008 (6/79)
DEPTH?
Robert
No.
SLOPE
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN . FT AND
CERTI FI ED SY~--4~.~t~'~'~
(minutes/inch)
FT