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HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 2 LT 40PERMIT NO. I'11_11'-,I T C i "FIL 'ir T'¢ OF DEPARTMENT'UF HEALTH AND ENVIRONMENTAL PROTECTION 825 tL' STREET, RttCHORRG5 PK. '93501 264-4?20 [-IELL PERM T T ( 810996 ) APPLICANT LOCATION LEGAL DOtIALD A. BRAY 16ii 1/2, #1, E. 16TH.. CHANDLRR ST., EAGLE RIVER L40 B2 EAGLE RIVER HEIGHTS S/D LOT SIZE ANCH. 10224 SQUARE FEET MINIMUrl DISTANCE BETWEEN A WELL AND ANY Of.I-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR i50 TO 200 FEET FRO~I A PUBLIC WELL DEPENDIt. IG UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM A PRIVATE HELL TO 8 PRIVATE SEWER LINE IS 25 FEET AND TO 8 COM~IUf. IITY SEWER LI~E IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT HITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY RPF'LY. SPECIFICATIONS AND CONSTRUCTION DIAGRAt'IS ARE AVAILABLE TO INSURE PROPER INSTALLATIOt. I. PERr~ I t E×P I RES DECEMBER I CERTIFY THAT I: I A~l FAMILIAR HITH THE REQUIREMENTS FOR ON-SITE SA.lEAS AND WELLS AS SET FORTH BY THE MUt. IICIPRLITY OF ANCHORAGE 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED' APPLICRt'IT DONALD A. BRRY by {~OC Co. dba SULLIVAN WATER WELLS P. O. 80X 2721CHUGIAKo ALASKA 99567 · TELEPHONE 688.2759 OWNER OF LAND ADDRESS LEGAL D~CRi~IO~ PE~M~ NUMBER L.u ~s ~ ~ C ~ ~TIC LEVEL OF WATER Ended KIND OF FORMATION: From ,~7 Ft. to ,.~3, 'Fi F~om ~ Ft. to From ~ Ft. tol--~2 'Ft. From ~.?.T Ft. to;~':~'' Ft. From ~' ~'~ Ft. to ~:~-~ Ft. From~ ~ Ft. to'~ .Ft. From ~;~: Ft. to I I< Ft. From //~ Ft. to!~ Ft. From Ft. to Ft, From Ft. to Ft. From Ft. to Ft~ From ~ Ft. I~ Ft From Ft. to .Ft._ From Ft. to Ft From__Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From From From~ From __ From -- From __ From .L From __ From __ From From From From · From Fi. to Ft. Ft. to Ft._ .Ft. to Ft.__ .Fi. to Ft, FL'to FI Ft. to~ Ft. Ft. to ' Ft._ Fi. to Ft._ FI[lo Ft. Fi. to Ft. Fi. to Ft. Fi. to Ft.' Ft. to Ft._ Fi. to ~t Ft. to Ft._ Fi. to Ft. Fi. to Ft, MISCL. INFORMA'HON: DRILLER'S NAME 17 "~' j ...... Tima T~me Dat~ Date Date Inspector Inspector Inspector Comments ~ ~,~. ~ndttiona, Approval late Sewer Install~ Permit No. ~ptlc Tank Size Holding Tank Size ~ils Rating Well To Absorption Area Well L~ R~elv~ Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Prope.yOwner-~O~g ~ ~'~ Phone , Buyer Realty ~. & Agent '~ Phone ~ddress ~ O~ ~ Street L~ation Typ~ Residence ~ingle Family ~ Multiple Family No. of Bedrooms ~ Other Wat~upply ~lnd[vldual A~ACH WELL LOG. A well log Is requlr~ for ail wells drlll~ since June ~ ~mmunity 1975. For wel~s drilled prior to that date, give well depth (attach log if ~ Public Utility ava~lable.~ Sewage Disposal Year Individual Installed: ~~ ~ Individual ~ Holdln~ Tank NOT~ THE INSPECTION FEE MUST ACCOMPANY ~CH REQUEST BEFORE PROCESSING CAN BE INflATED. MUHUPA UTY OF ° HCHORA G 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. 050-282-17-000 Expiration Date: Legal description EAGLE RIVER HEIGHTS BLK 2 LT 40 Site address 10222 CHANDALAR ST Eagle River AK 99577 Current property owner(s) WILLIAMS JORDAN & JEANNETTE 11/21/2023 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 8/21/2023 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 x Tank Age Advisory Arsenic Advisory Other COSA Approval June 2022 MUHMh` , DUTY Old /\ HCHO RAGE O �€ ' 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. 050-282-17 Complete legal description Eagle River Heights Block 2 Lot 40 Location (site address) 10222 Chandalar St. Eal4le River, AK Current property owner(s) Jordan & Jeannette Williams 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 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 $ 2.'�50 Date of Payment COSA # 025C 23 J 2,o g Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist Legal Description: _ _ _Eagle_ River Heights Block 2 Lot 40 Parcel ID: 050-282-17 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA F/I Well log is filed with Onsite (or attached) Date drilled 10/20/81 Total depth 120'8" ft Cased to 12018"ft 0 Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12 in. Date of flow test for COSA 8/1/23 Static water level at beginning of test 67 ft. Comments Measured operating fluid lev tank Date of pumping ❑ Required maintenance completed, if AWWTS Comments: ABSORPTION FIELD DATA Which tem tested (date installed) ❑ ALL standp s present per record drawing Total measured depth m grade ft (max) Measured depth to pipe inve om grade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insula ❑ 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 Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 5.3 qpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes R] Nc ✓❑ Coliform bacteria is Negative Nitrate 6.50 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ✓❑ Arsenic less than MRL (ND) Collected by Arcterra Consulting Date 8/1/23 C. LIFT STATION ❑ Required maintenance completed e of lift station years Lift station ma Comments: 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 LD�STTATUS — POST RECOVERY Effec depth (per record drawings) Effective dep sed in Effective depth rem g in in 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' if No ft Tank to Property L�[�:] Community Sewer Manhole/Cleanout > 100' ❑ Yes if No NA ft 0 Yes if No Neighboring Tank > 100' ✓❑ Yes if No ft Private Sewer/Septic Line > 25'JO Yes if No Absorption Field on Lot > 100' ❑ Yes if No NA ft Holding Tank > 100' Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50'J❑ Yes if No Rv Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ✓❑Yes if No ft ❑✓ Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water Ting Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundatio�eL if No ft Tank to Property L�[�:] r 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 F. ENGINEER'S COMMENTS Surface Water > 100' Wells on Adjacent Lots: Private Wells > 100' Community > 200' ft ft ft ft ft ❑ Yes if No ft ❑ Yes if No ft ❑ Yes if No ft If tank or field is under driveway ro fimsb�elow 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 Arcterra Consulting Phone (1907)-646-6111 Engineer's Printed Name Kenneth Duffus Date B /7 0Z3 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 AP surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluators—. of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will 0 function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen 'PA encroachments, deficiencies or discrepancies exist • COSA Checklist June 2022 DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC231308 Subdivision: Eagle River Heights, Block: 2, Lot: 4 907-343-7904 Fax: 343-7997 A water sample revealed a nitrate concentration of 6.50 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/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. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. w =Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org EP LANS MUNICIPALITY OF ANCHORAGE ,• r Development Services Department ;' 4 % Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 050-282-17 Expiration Date: (0—17 '( 9 1. GENERAL INFORMATION Complete legal description EAGLE RIVER HEIGHTS BLOCK 2, LOT 40 Location (site address) 10222 CHANDALAR STREET, EAGLE RIVER, AK 99577 Current property owner(s) GARY G. KLECKA Day phone Mailing address 10441 PALOS VERDES CIRCLE, EAGLE RIVER,AK 99577 Real estate agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) U Duplex E Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Private Septic n Private Well ® Holding Tank ❑ Water Storage — Community ❑ Community Well n Public Sewer Public Water System n Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ SSO Waiver Fee $ Date of Payment /I rslA Date of Payment Receipt Number Q a3(4"-7-1) Receipt Number COSA# Os( 19 13O(J 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm ANDERSON CONSTRUCTION&ENGINEERING Phone 345-3377 Address 4661 NATRONA DRIVE, ANCHORAGE,AK 99516 Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 07/12/2019 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, QF Az\ local soil characteristics,groundwater levels that may fluctuate during the year,quality of isv.,\S'.... ��CIS1construction(workmanship&materials),the water usage of the family being served by the1 system and maintenance. The operational life of all well and septic systems are subject to C . �)— •` ' these various and dynamic characteristics and are outside the control of the evaluator of the * :4 9 TIi /\ *,/ well and septic system. Therefore,any estimate of how long a system will function satisfactory �%'�1�i(J� for current or future occupants or guarantee that no unseen encroachments,deficiencies or discrepancies exist can be given by 4.4 F Sand Anderson Construction&Engineering. . + ..]IQCHAEL N. ANDERSON. 1 No. CE 9489 4. / 6. DSD SIGNATURE , 7/12/19 .. � \ System#1 Approved for 3 bedrooms ssio��' \NI\__4111°. System#2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: �•` lllt TYf( r(Or (( r 14`0 �� ON-S1TE do _� 44 rER AND m ,fit WASTEWATER ...... - 0 PROGRAMe: .,,_•_- , * , ,i, ..c:)\--1i) SER\RCti#\ am )))))))))1111 By: I t,,,...._t,,,...._ _ Original Certificate Date: 1. 7 _ / 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: X COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: EAGLE RIVER HEIGHTS BLOCK 2, LOT 40 Parcel ID: 050-282-17 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Water storage tank volume NA gallons Date drilled 10/20/1981 Well disinfected for coliform test? ❑ Yes ® No Total depth 122 ft ® Coliform bacteria is Negative Cased to 120 ft Nitrate 7.03 mg/L ❑ Nitrate less than MRL (ND) ® Sanitary seal is functioning correctly Arsenic ug/L ® Arsenic less than MRL (ND) ® Wires are properly protected f wcs Casing height (above ground) 12+ in. Collected by - Date of flow test for COSA 7/9/2019 Static water level at beginning of test 71 ft. Date of Sample 7/9/2019 Well production at time of test 5.4 gpm Comments B. TANK DATA - PUBLIC SEWER C. LIFT STATION Age of tank(s)years ❑ Required maintenance completed Tank type/material Age of lift station years Measured operating fluid level in septic tank Lift station material ❑ Standpipes/foundation cleanout per record drawing Comments: Date of pumping D. ABSORPTION FIELD DATA - PUBLIC SEWER Which system tested (date installed) Adequacy test date ❑ ALL standpipes present per record drawing Results ❑Pass For bedrooms Total measured depth from grade ft (max) Fluid depth prior to test in Measured depth to pipe invert from grade ft(min) Water added gal ❑ N/A–pressurized field New depth _in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective ❑ Code-required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: FW�� COSA Checklist copy.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot> 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' Z Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Z Yes if No ft ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Wells on Adjacent Lots: Property Line > 5' ® Yes if No ft Private Wells > 100' E Yes if No ft Absorption Field > 5' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Main > 10' ® Yes . • ft If septic tank is under driveway comment blow Water Service Line > 0' ® Yes if No ft S •- - f ater> 100' Z Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field • - •er driveway comment below Property Line > 10' ® Yes if No _ft - s on Adjacent Lots: Water Main > 10' ® Yes . • ft Private Wells > 100' ® Yes if No _ft Water Service Line > a' ® Yes if No ft Community Wells > 200' ® Yes if No S • ► ater> 100' ® Yes if No ft F. ENGINEER'S COMMENTS A% % OF ALS G. ENGINEER'S CERTIFICATION Aor <S,. ''4..6). i I certify that I have determined through field inspections and review I*49 TH /\ of Municipal records that the above systems are in conformance / iiii/2U„J with MOA COSA guidelines in effect on this date. I, -.MICHAEL N. ANDERSON.: / No. CE 9469 / 1 ... 7/15/19..•• s' COSA Checklist copy.docx ` FESSIC14` MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT (s , f r ' i 907-343-7904 On-Site Water and Wastewater Section /) Fax: 343-7997 www.muni.org/onsite Nitrate Advisor Certificate of On-Site Systems Approval # 0SC191304 Subdivision: Eagle River Heights, Block: 2 , Lot: 40 A water sample revealed a nitrate concentration of 7.03 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/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. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.O. Box 196650 * Anchorage,Alaska 99519-6650 *www.muni.org Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address: P.0. Box 196650*Anchorage,Alaska 99519-6650*www.muni.org