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Home My WebLink AboutTURPIN #1 BLK 1 LT 16 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 WALTER J, HICKEL, GOVERNOR 563-6775 RECEIVED Mr. Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 July 23, 1991 JUL 2 4 1991 Munic~pah[y ot Anchorage Dept, Health & Human Services Subject: Lot 16, Block 1, Turpin Subdivision #1, Anchorage Alaska, Class C Public Water System (PWSID Number 216889), ADEC Project Number 9!21-FA- 038; Review Dear Mr. Shafer: This is in response to your submittal, received in this office on July 5, 1991, regarding the above-referenced Public Water System. I have completed my review of the submitted information and the office's file on this facility. Based on my review, I have the following comments: It appears that the Class C Public Water System Source Well and supply system located on Lot 16, Block 1, Turpin Subdivision was installed substantially in conformance with State Drinking Water Regulations and the construction approval issued on February 6, 1991. Therefore, the Public Water System is approved for the concerns of this Department, in accordance with the provisions of 18 AAC 80, Drinking Water Regulations. The Final Operation Certificate, constituting this approval, is enclosed. At this time, the Department is assigning Public Water System Identification (PWSID) Numbers to all Public Water Systems in the State. The PWSID Number that has been assigned to this public water system is .216889. The current State Drinking Water Regulations do not require routine water sampling for Calls C Public Water Systems such as this system. The Department would like to be able to contact the owner/operator of the system in the invent of a problem or changes in the regulations. Please have your clients complete the highlighted areas on the enclosed "Inventory Update Form" and return it to this office. Thank you for your cooperation with this Department. If you have any questions, please do not hesitate to contact me. S~cerely,/// j~//~ Keven K. Kleweno Environmental Engineer Enclosures: As Stated cc: John Smith, DHHS, w/o Enc. ¢:~ ~,,.,.~o.,.cyc,eop.o~,, DEPT. OF ENVIRONMENTAL CONSERVATION ' - ~' AK 99577 ~'~- q l '~ 204 WALTER J. HICKEL, GOVERNOR Februauy ~ lqe] ' . Sn~fe~: 9ear ~ir -! ~ -. ' - '~-' recelveo in -tns_s o~J.. on u~ .... ',, 4 1991, in ~ v~ ~- yOU .... - .... d '~":~ " re~ersnC~ ~o~. i have comoteteo my review of tile j.~ ..-~-. 4 -~ . =~,~ ~ ~.~ ~' ~' ':project. 7oliowing are ._~o~:.~t~o,, and tnlS o~ ...... O~ .... , ..... n~-s ........ ' '' is project ..... ~ ~ ~ , -: .... a in'Formanion, only "[' ~ ~ocation of the: at *" ~ '-~- bv '- Deoartmen~. The location of tile ~..o~:.o._ is approvefl for concerns oa =~,,~ D~,y .... -~ ~, ..... orov~s~ons of 1S '~ .... "~ ~- 'nistrat~ve 2ode nO, Drlnk:tn9 ,?auer. , , ~ ~={c,=~ ,~o~.=u ..... ~ ~ ,.-,:~n approval ~ Construction ,~=t~a...~-, ~ ~{~,,t~nc this only for tile ~ ~- ~ .-_~ ~ .... ~ ' t,he well of the r.~' .- ..r, water system ' '~ is subject to the following !. Plans to be submitted under the stamp of a Eng~n=ez (PD) ~ccomo!lshed) ....... ,:~-=~ under the sEa:nD of a P~ that there oou~o contamlnatlon wi''" 150 =oo~ .... bacter lolog ~z anu ~ ........... ,-=~.~ '~ results -4. Satzsf~tu=z an~z inorganic contaminates (nitrate (as n._t,ou~n)) ~'~ need to h'a provided to ~'~'~- =~:~ '-=~o~-.~ SarviAg ='~ ..... (~.]~t zn S/D ~}1, Lot ~' s!k !) 5. Ver'~-:ication ~ u=~ the s:aa~/O Of a D,~ =~ -~' the vm!l was ~o~n~toned ~ accor!s, nce ~-;ltn ,:~un~ -~ =' -," (enclose~) This approval does hOC imply the granting authorizations nor obligate any state, federal, body to grant required authorizations. of any additional or local regula[ory Thank you for your cooperation with this Department. If you have any questions, please do not hesitate to contact me. Sincerely, Environmental Engineer enclosures cc: John Smith, Di-U{S ~;/o enc. TAi[/skpf CRG STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION , CONSTRUCTION AND OPERATION CERTIFICATE of. 'At LA,S for PUBLIC WATER SYSTEMS A. APPROVAL TO CONSTRUCT I Plans for the construction Qrmadifiesill of TI�� SQt11��E t�7GG� Sri �►J(T G G`i� [a� public water system located ' in A N C t4of? i) (;r Alaska, submitted In accordance with 18 AAC 80.100 by S S N } , rwU Fo R 554c ipa g-'D $fao KA�have been reviewed and are ❑ approved. �. conditional y approved (see attached conditions). SF—F, hD97C. LT(L BY — — TITLE — DOE If construction has not started within two years of the approval date, this certificate Is void and new plans and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contract order no. or descriptive reference) C. APPROVAL TO OPERATE Approved by Date The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water is made available to the public. The construction of the .. public water system was`•completed on --(date). The system is hereby granted interim approval to operate for 90 days following the completion date. BY TITLE DATE As -built plans submitted during the interim approval period, or an inspection by the Department, has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. BY TITLE DATE 611zi- A-037 12 89 > Feb4ua4y 1, 1991 �9Q�� R1VERAI.P5,�4 HEALTH AUTHORITY APPROVALS State o4 Ata6ka DEPARTMENT OF ENVIRONMENTAL CONSERVATION 3601 C Staeet Suite 322 Anchorage, AtaAka 99503 SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERTSHAFER, P.E. ROGER SHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 RECEIVED F E B 04 1991 ANCHORAGE/WESTERN DISTRICT OFFICE REFERENCE: Lot 16; B.2ock 1; Tunpin Subdivizion 01; Request you issue appxovat2 to dkitt a new C-Ea4s 'C' we?Q, on the nebeneneed pnopenty to heave an ex.r4t ng dup.Lex. The pnopenty iz eunaentty owned by H.U.D. white the paopenty manageA -us ASSOCIATED BROKERS, 640 Wat 36th Avenue, Anchorage, Ak. 99503, phone #563-3333. We have seanehed State 9 Mun.icipat bites but have been unab-ee to 4ind any documentation o,% appnovats 4on the existing Class ICI wets. As can be seen jnom the zite plan attached, th.i4 wett i4 too close to the existing Municipa...6ewen tine. Ij you have any questions, on. %equi,%e add.iti.onat .inbonmati.on 4on your. u's. 11-1 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 I SCALE LIZ- L� -lz r 0 .A. , t. r cn x f e _ t: t:' � V 7 • a 7 ANCHORAGE DISTRICT OFFICE 563-6775 3601 C Street, Suite 322 Anchorage, AK 99577 February 6, 1991 Mr. Robert A. Shafer, P.E. S & S Engineering 17034 Ragle River Loop, Suite 204 Eagle River, AK 99577 Rat Lot 16, Block 1, Turpin Subdivision il, Anchorage, Alaska, ADSC Project Number 9121-FA-038, Installation of a Class C Public Water System Source Well, Review. Dear Mr. Shafer& This is in response to your submittal, received in this office on February 4, 1991, in which you requested to drill a well on the referenced lot. I have completed my review of the submitted information and this office's file on this project. Following are comments concerning this project. Massed on the submitted information, only the location of the proposed Class C Public Water System Source Well can be approved at this time by the Department. The location of the proposed well is approved for concerns of this Department, in accordance with the provisions of 18 Alaska Administrative Code 80, Drinking Water„ A Construction Certificate, constituting this limited approval is only for the location and installation of the well of the referenced water system and is subject to the following r equ i remen tss & 1. Plans to be submitted under the stamp of a Professional Engineer (PE). (Accomplished) 2. Written verification under the stamp of a PS that there are no known sources of contamination within a 150 foot radius of the proposed well. (Accomplished) 4. Satisfactory analytical results for bacteriological and inorganic contaminates (nitrate (as nitrogen)) will need to be provided to this office before serving water to the public. Samples should be submitted under the Public Water System ID 4 216899 (Turpin S/D il, Lot 16, Hlk 1). 5. Verification under the stamp of a PE that the existing well was abandoned in accordance with "Groundwater Well Abandonment Recommendations". (enclosed) "0 This approval does not imply the granting of any additional authorizations nor obligate any state, federal« or local regulatory body to grant required authorizations. Thank you for your cooperation with this Department* rt you have any question$, please do not hesitate to contact me. Sincerely, r Timothy A. lear"waki Environmental Engineer enclosures ays John Raith, DHHS a% one. TAK/skpt ,4 MAY- S-9 1 MON 1�4 � rr-�� ASSOC I ATED EROK... . S r I NG _ P _ 02 ' / } , -,) Well Log Alaska Now Well/Vern"s Drlilllna 12241 Avlon Anchorage. Alaska 99516 (907) 345-4417 AA3S27 Location or Wen Borough I Subdivision Lot I Block ISection IRI I Range JEJ IlIerdlen Anchors a Turoin 01 161 11 1 1S W 701 Edwards Well Log Ft. Below Surface material Tvne Tan Bet.lnm sandy, gravely till. cobbles 0 25 gray silty gravel 25 35 ibrovel brn till 3S 75 gray silty till 75 80 gravely silty till, wet 80 89 :heaving pea gravel with sand. H2O 69 93 gilt 93 148 ray CIOX & silt, little gravel 148 150 perforated well 89- 91' 6" pumping 12 gpm for 2 hrs, 10' d.d, to check well now Well Depth (ft) Date of Completion 1501 4/15/91 Drilling Method Use rotarydomesttt Casing T pa welded Diameter On,) Depth (ft.) Weight (lbs/ft) S to 1501 to E I Finish of Well T pe Diameter perforated 51 Static Water Level Level (ft.) Date 56 4/15/9i Pumping Level Below T of c (ft.) After Ors) Pumping (.p,m) 66' 21 12 Grouting Yes Material No x I Pump H,P, —capacity Type 11 32061 submersible Setting (ft) 96 Remarks old well bentonits grout sealed as suggested casing cut-off 4'below surface and steel cap welded on. well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief, Authorized Representative bate Vernon L. Nowell 41161911 R ECEIVE D 17034 Eagle River Loop Road J U L 11991 ROBERT A. SHAFER Eagle River, Alaska 99577 DEPARTMENT OF CIVIL ENGINEER mviRONME AALCONSERVATION� 694-2979 �� PROJECT: r DATE OF TEST::�P.�II LOCATION OF WELL (Legal Description): _� o-E 1 ,D ► nJ a-S t WELLDEPTH:. ( ±Z., ( FT. CASINO:. 1 Q FT. SCREEN: DATE DRILLING COMPLETED. _ — % ` I I DRILLER: tlr11)/A� ,f STATIC WATER LEVEL Crop of Casing): _ ~ FT. .DATE% je3 — .-2, — CLOCK TIME ELAPSED TIME SINCE PUMPING STARTEDI STOPPED, MIN. DEPTH TO WATER, FT. DRAWDOWNI RECOVERY PUMPING RATE, OPM REMARKS 0 0 0 (swq 1 0 0 Start 1 W 5 10 15 O ❑ 20 I 25 61 -112 30 1. 1^ 35 61 D 40 leiI 45 +a C 50 ' 55 00 60 0 hour) I '' p 90 o ❑ 120 (2 hours) I 5 150 180 113 hours) + p 210 240 (4 hours) 1,2p RECOVERY t 0 0 Es ' 10 i•In. r 15 20 25 30 35 Comments: FIOW 1� 11RIj Guaranteed �e dj �e� — 9 P "'� 0eASubsequent Variations A4 h o u r (p e r i ocl Can Occur. � es S A -- I �Q z c — M 31VOS CHEMICAL & GEOLOGICAL LABORATORY 480F.I.T. A DIVISION OF COMMERCIAL TESTING & ENGINEERING 5033 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS REPORT BY SAMPLE for WOREorder# 34216 Date Report Printed: MAY 15 91 ! 15:09 Client Sample;ID:L16 B1. TURPIN 3/D #1 PWSID :UA y Collected MAY 13 91 # 17:00 hrs. Received MAY 14 91 a 14:00 his. Preserved With :AS REQUIRED Analysis Completed :MAY 15 91 Laboratory Supervisor :S EPHEN C. EDE Released By Chemlab Ref #: 911996 Lab Smpl ID: 9 Matrix: WATER Parameter Tested Result Units NITRATE-N ND(0.10) mg/l Sample ROUTINE SAMPLE COLLECTED BY: R.D.J. Remarks: Client Name :S & S ENGINEERING Client Acct :SNSENGP BPO # PO # NONE RECEIVED Req # Ordered By :R. SHAFER Send Reports to: 1)S & 3 ENGINEERING 2) Allowable Method Limits EPA 353.2 10 .............................................................................................................. 1 Tests Performed See Special Instructions Above UA-Unavailable ND- None Detected See Sample Remarks Above NA- Not Analyzed LT -Less Than, GT-Greater Than I :ate Received. STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION APPLICATION FOR ON -SITE WATER AND SEWER SYSTEM APPROVAL L GENERAL INFORMATION Legal Description of the Location l (.- T_-2 L--tL 1 -cD �,z Applicant Name AD •I'cant is: (Check one) Bank r]Certi.fiad Installer No. Owner/Builder Q)Z Address (Street or P O Box) yt_ Type of Hasidence Total No. of Bedrooms LA�(�-'= %�% ❑Single Family Multi -Family City, State and Zip Code Telephone Send Approval to S & S ENGINEERING _ q ElApplicant Other: (Give Name & Address) E� glRI+Y " 1 -7 Eagle River, Alaska 19577 II. WATER SUPPLY SYSTEM Source of Water and Containment (Check all that Apply) Type of Water Supply System Treatment of Water (Check all that Apply) Surface (Identify) JQ�Well (Drilled or Driven) El Surface . private ❑Chlorination /❑ Roof Catchment Other (Identify) El Public (Serves more than one ��❑///None �Jy,Filtratinn �` ❑Mineral Removal ❑ Holding Tank family) ❑Other: V I L�CIJ Well Data Is the Height of the Well Casing more than 12" above the Ground? �L /� py, Yes ❑ No i Is a sanitary seal installed on the well casing? VJ j'�j ) j=G��QJ 1 T Yes ❑ No Is drainage directed away from or around the casing within a radius of 10 feet of the well casing? ❑ Yes No Date Drilled Depth of Well (Fret) Static Water Lgvel (Feet) Yield ailable) JPump Rate (If v i le)) Q 1d; l l j 4f4 �Z — Gal/Min 1l0 Gal/Min Separation Distances from the Well Casing to each of the Following Sources of Contamination: Septic/Hol,di11ng Tank on Lot Sewer Lines on Lot Absorption Area on Lot No� k� NlAY( �i Closest Septic`/Holddiin1g Tank on Adjacent Lot Closest Sewer Lines on Adjacent Lot Closest Edge of an AbsorptiomArea on Adjacent Lot If toxic materials are stored on the property, including fuel tanks, paints, lubricants and other petroleum based materials, pesticides, fungicides or herbicides, indicate distance from contaminants to well casing: On Lot (1G On Adjacent Lot I' 1 0C) w10 bW r" 1v Water Sample Taken by: Name S & S ENGINEERING Sampler Is: 17034 Eagle River Loop Road N ❑ Buyer Pr- Engineer Address Eagle River, Alaska 99577 ❑ ❑ Banker Government Official Water Sample Results: Attach Copy Satisfactory -Date: IQ "7 — 01 ElUnsatisfactory -Date: �C ,ments/Recommendations: ti� Pal �c-rt�- E��i-� T>-- -:7.5r-� P � �o �. �-• -bf�C,� _= �►t,t..--rrr-r y c� I certifyAlat the bova information is carr l•,, Sbtf/PrInted NamLoop TC(/�L / Date �rzv gla River Load Road No. 204 NOTE: Must be signed by aCertified Installer, Professional Engineer, Department of Environmental Conservation or the Owner/Builder III. WASTEWATER DISPOSAL f r Tank/Absorption System Holding Tank - Capacity of Tank Specify; ❑ Septic Tank Outfall Discharged To: ❑ New System Name of Installer Package 7-reetment: IJ ❑ (Specify Brand Name or Process) Where Waste is Disposed Frequency of Pumping ❑ (Outhouse, Incine� ram t Date Installed ❑ El OCertified Installer ❑ Other: Type/Manufacturer wnor er No. Septic Tank Size (Gallons Number of Compartments Soil Type or Rating Type Soil Absorption System Dimensions/Size Soil Absorption System Type/quantity Backfill Material used for Soil AbsorpYlon System Percolation Test Results Percolakio si by: (Name) Minimum Ground Cover over Absorp- Minimum Ground Cover over Septic out Pipes/Caps Installed on leanout PlppslCapB Installed on tion area Tank Sept nk bsorption 5yst4m Feet Feet ❑ ❑ No Yes ❑ No Yilaxer Supply Source on Lot Nearest water Supply Source on AdjanenY Naa Body of Water Water Table/Bedrock Lot Line Separation Lot Distance to: Feet Feet i Feet Feet Comments/Recommendations certify that the above information is correct: Signature Typed/Printed Name Title, Reg. /Cert. No., Inst. No. Date NOTE: Must be signed by a certified installer, professional engineer or DEC Staff. ❑ Existing System Nametof Installer Date Installed ❑ OwnerlB er ❑Certified Installer ElOther: Type/Manufacturer No. Septic Tank Size (Gallons Number of Compartments Soil Type or Rating Type Soil Absorption System Dimensions/Size Soil Absorption System Type/Quantity Backfill Material used for Soil Absorption System Adequacy Test Results: AdequacyTast adBy: (Attach Copy of Report) Date Septic Tank Pumped (Attach Copy of Receipt) ❑ Pass ❑ Fail Minimum Ground Cover over Absorp- Minimum Ground Cover over Septic Cleanout Pipes/ a tailed on Cleanout Pipas/Caps Installed on tion Area Tank Septic Tank Absorption System Feet Feet ❑ yps No Yes ❑ No Separation Water Supply Source on Lot Nearest Water Supply Source on Adjacent Nearest Body of Water Water drgrk Lot Line Lot Distance to: Feet Feet Feet Feet Feet Comments/Recommendations I certify t>k the ab9fie information is correct: Signatu T ped� Pr q te_ Title, Reg.ICert. No., Inst. No. Date 5 b PYfG'1i {tLll1%, OTE: Must be signed by a profes n r- r 77 ,or� • r• •- g 01 ti �' :•i. < ■ d • "� •r.� e rstia�ssi. r U OF 'P NJ s 5 STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE for PUBLIC WATER SYSTEMS A. APPROVAL TO CONSTRUCT Plans for the construction or-wtodg .at4eft of in _ .... by public water system located Alaska, submitted in accordance with 18 AAC 80.100 have been reviewed and are ❑ approved. Q, conditionally approved (see attached conditions). BY TITLE DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contract order no. or descriptive reference) Approved by Date C. APPROVAL TO OPERATE The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water is made available to the public. The construction of the public water system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the completion date. BY TITLE DATE As -built plans submitted during the interim approval period, or an inspection by the Department, has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. BY TITLE DATE 18-0407 (Rev. 11I83) DISTRIBUTION: 1. WHITE - ENGINEER (Complete Section C) 2. YELLOW - WATER SYSTEM FILE (Complete Section C) 3. PINK - ENGINEERIMUNI-BOROUGH (Complete Section C) 4. GOLDENROD - MUNI-BOROUGH (Complete Section A) JU Q SN WALTER J. HICKEL, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 563-6775 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 Mr. Robert A. Shafer, P.E. July 23, 1991 S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 Subject: Lot 16, Block 1, Turpin Subdivision #1, Anchorage Alaska, Class C Public Water System (PWSID Number 216889), ADEC Project Number 9121-FA- 038; Review Dear Mr. Shafer: This is in response to your submittal, received in this office on July 5, 1991, regarding the above -referenced Public Water System. I have completed my review of the submitted information and the office's file on this facility. Based on my review, I have the following comments: It appears that the Class C Public Water System Source Well and supply system located on Lot 16, Block 1, Turpin Subdivision was installed substantially in conformance with State Drinking Water Regulations and the construction approval issued on February 6, 1991. Therefore, the Public Water System is approved for the concerns of this Department, in accordance with the provisions of 18 AAC 80, Drinking Water Regulations. The Final Operation Certificate, constituting this approval, is enclosed. At this time, the Department is assigning Public Water System Identification (PWSID) Numbers to all Public Water Systems in the State. The PWSID Number that has been assigned to this public water system is 21. _ 6889. The current State Drinking Water Regulations do not require routine water sampling for Calls C Public Water Systems such as this system. The Department would like to be able to contact the owner/operator of the system in the invent of a problem or changes in the regulations. Please have your clients complete the highlighted areas on ithe enclosed "Inventory Update Form" and return it to this office. Thank you for your cooperation with this Department. If you have any questions, please do not hesitate to contact me. Si cerely, PA.4t7 Keven K. Kleweno Environmental Engineer Enclosures: As Stated cc: John Smith, DHHS, w/o Enc. ia MEMORANDUM STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION DRINKING WATER AND WASTEWATER PROGRAM 555 Cordova Street, Anchorage, Alaska 99501 Date: December 5, 2002 To: Lot 16, Turpin Subdivision Thru: Keven Kleweno, RE Environmental Engineer From: Jenna Summerville College Intern Subject: Reclassification of Lot 16, Turpin Subdivision from a Class C Public Water System to a private water system (PWSID 216889). In the modifications of the State Drinking Water Regulations that were finalized on October 1, 1999, water systems serving duplexes were reclassified. In this regulation change, water systems serving duplexes were reclassified from Class C public water systems to private water systems. Due to this reclassification all water systems serving duplexes found in the Drinking Water and Wastewater (DW/WW) Program database will be placed in delete status. All information will be kept in the DW/WW Program hard files. As a result, the above referenced property has been placed in delete status in the DW/WW Program database. Operation approval issued on July 22, 1991. Cc: Jamie Stazel, ADEC, DW/WW Program 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 Parcel I.D. 006-094-20 Legal description TURPIN #1 BLK 1 LT 16 Site address 701 EDWARD ST Anchorage AK Current property owner(s) WUERTZ Expiration Date: 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: 10/31 /2023 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 Arsenic Advisory Other COSA ApprovaUune 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. 006-094-20 Complete legal description TURPIN #1 BLOCK 1, LOT 16 Location (site address) 701 EDWARD STREET, ANCHORAGE, AK 99504 Current property owner(s) ADAM WUERTZ Day phone 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ 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: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ® Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ 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 $ Z g (� Date of Payment COSA # D s G 23 f '-I Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist WELL ONLY.docx COSA Checklist Legal Description: TURPIN #1 BLOCK 1, LOT 16 Parcel ID: 006-094-20 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 4/15/1991 Total depth 150 ft Cased to 150 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10/19/2023 Static water level at beginning of test 45 ft. Well production at time of test 5.2 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 0.552 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 10/19/23 Comments Attached ADEC & AWWU documents with photo of utility room with basic pressure tank & 2 hot water heaters. 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 10/31/2023 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 & 10/31/23 m 1. mar- woo 'All = w y lI /I% RKS TROII /I S TREE T 5 survey ordered by: dar walden keller williams WOOD FENCE WOOD FENCE �qs��o >: 49 TH*C 0 SHANE A. HOLT i P LS-6914 �ArOfessiona� �'Qo �0�0000�� AS -BUILT SURVEY I" = 20' NO CORNERS SET THIS DATE 1 HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT16 BLOCK 1 TURPINSUB THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY, OR ANY ENTITY NOT ON THE RECORD PLAT THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS ARE NOT SHOWN HEREON, UNLESS NOTED. EXIST OTHER THAN NOTED. NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE DATED AT ANCHORAGE,ALASKA THIS 18 TH DAY OF PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. OCTOBER 2023 ANY PAVING SHOWN HEREON MAYBE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. ONLY VISIBLE IMPROVEMENTS ARE SHOWN HEREON HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGEAK 99507 223-8615 15951 234-60