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
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· From
Fi. to Ft.
Ft. to Ft._
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.Fi. to Ft,
FL'to FI
Ft. to~ Ft.
Ft. to ' Ft._
Fi. to Ft._
FI[lo Ft.
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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:
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, *
, ,i, ..c:)\--1i) SER\RCti#\ am
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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