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RABBIT CREEK VIEW & HEIGHTS BLK 6H LT 11A
Onsite File Rabbit Creek View & Heights Block 6H Lot 11 A #020 - 561 - 48 Tfefi-y Drilling, 41nc. C----- L Well Log Warr la( `Drfiiiiij alls(Pftnip SerViC,: :411CrIerat1C,`,ArtISta ( 07) ::-45-05. 3 Drilling Started: OS 29 2QQ_7compicied:Q8..29 2007 CityiBorough: Subdivision: BLOCK LOT Property Owner Name&Address:Clint McCool Anchorage Rabbit Creek Hgt 6H 11A 3729 Rinner Circle Site: Bear Valley Anchorage, AK 99507 Meridian Township Ranee Section____._ _______ 1/4 of _. 1.4 of Vi of _. 1/4 I BOREHOLE DATA(from top of casingPepth Drilling method:(X I Air rotary. ( ) Cable tool.Other Material:Type,Color&wetness Front To Well use:( )Public supply. (x)Domestic, Other i stickup 0 2 Depth of hole: 54 ft,Casing stickup: .......__2______ft Ctising.type:*epl __ Thickness:_.25O _'boles 54 fill 2 4 Casing diameter: 6 _ inches Casing depth: Liner type: - Diameter: - inches Depth: - ft Peet 4 8 Static water(from top of casingyarteSiarit on0 ; 8!?9 2007 Pumping level&yield: feet after hours at . spm Recovery rate: 15 epm.Method of testing: airlift silt & gravel 8 22 Development method: airlift Duration: 1 hour moist silt & gravel 22 30 Well intake opening type: ( X) Open end.( )Open hole.Other_ _ Screened: Start: - 11,Stopped_ _ .__7____._ ft dry silt w/gravel 30 50 Screen type: - Slot/mesh size: _ Perforated:Start: - ft.Stopped: _ ___ - ft gravel w/ H20 50 54 Start: - It.Stopped: - 11 Note: Grout type: bentonite Volume - Depth; from ground surface ..To 20 fi Pump intake depth: _ 11 Pump size: . hp. Brand name: ---- Was well disinfected upon completion? IX)Yes. ( )No Method of disinfection:Calcium.H.ypoctilorite..(Chlorine.)... Driller comments::disclaimers: Well driller name:.Johnny Kay Company name: Hefty Drilling, Inc. Mailin4,address. 3540 Akula Dr. city: Anchorage State:AK Zip 99516 Phone number:( 907 ) 345 - 0593 fax:345-4700 Drillers siunature: Municipality of Anchorage Attention: Property owner shall provide a well log to the Development Services Department DSD within 60 days of well completion. Building Safety Division Permit Number:land use permit Class C On-Site Water and Wastewater Section Date of Issue: / / 4700 South Bragaw St. — P.O.Box 196650 Anchorage,AK 99519-6650 Parcel Identification Number — Is well located at approved permit location?(x)Yes or ( )No www.muni.orglonsite (907)343-7904 STATE OF ALASKA 33508 `\ DEPARTMENT OF NATURAL RESOURCES / DIVISION OF MINING, LAND&WATER 1-i Alaska Hydrologic Survey 4 V �/ ,,,b p.Wt„,`.0 WATER WELL LOG Revised 08/18/2016 Drillin• Started: / / Com•leted: 8 / 29 / 2007 Pum• Install: / / City/Borough Subdivision Block 1 Lot Property Owner/Name&Address Hope RABBIT CREEK HEIGHTS B6H Ll 1A C MCI[ O O L ' Well location:Latitude Longitude V t \.J Meridian S Township 011N Range 003W Section 1 114 of 1/4 of 1/4 of 1/4 BOREHOLE DATA:(from ground surface) Drilling method:®Air rotary,fable tool,❑Other Suggest T.M.Hanna's hydrogeologic classification system' Well use:❑Public supply,❑Domestic,❑Reinjection,❑Hydrofracking https://mv.ngwa.orq!NC Product?id=a185000000BYub3AAD Depth 0 Commercial,❑Observation/Monitoring,❑Test/Exploratory,❑Cooling, From To ❑Irrigation/Agriculture,❑Grounding,❑Recharge/Aquifer Storage, stick-up 0.0 2.0 ❑Heating,❑Geothermal Exploration,00ther fill 2.0 4.0 Fluids used: peat 4.0 8.0 Depth of hole: 54 ft Casing stickup: ft Casing type: Casing thickness: inches silt and gravel 8.0 22.0 Casing diameter: inches Casing depth: 54 ft moist silt and gravel 22.0 30.0 Liner type: Depth: ft Diameter: inches dry silt with gravel 30.0 50.0 Note: FULL CASE gravel with water 50.0 54.0 Well intake opening type:©Open end,©Open hole,❑Other Screen type: , Screen mesh size: Screen start: ft, Screen stop: ft, Perforated❑Yes 0 No Perforation description: Perf from: ft, Perf to: ft, Perf from: ft, Perf to: ft Gravel packedEYes 0 No Gravel start: ft, Gravel stop: ft Note: Static water(from top of casing): ft on / / Artesian well E Pumping level&yield: feet after hours at 15 gpm Method of testing: Development method: Duration: Recovery rate: gpm Grout type: Volume Depth: From ft, To ft Include description or sketch dwell location(include road narneT7 Final pump intake depth: ft Model: buildings,etc.): Pump size: hp Brand name: Was well disinfected upon completion?Q Yes D No Method of disinfection: Was water quality tested?fjYes E No Water quality parameters tested: Well driller name: Company name: HEFTY DRILLING Mailing address- 4, City: State:AK Zip: Phone number: ( ) - AS 41.08.020(b)(4)and AAC 11 MC 93.140(a)require that a Drillers signature: copy of the well log be submitted to the Department of Natural Resources within 45 days of well completion.Well logs may Date: / / be submitted using the online well log reporting system Anchorage Municipal Code 15.55.060(I)and North Pole Ordinance 13.32.030(D)require available at: that a copy of this well log be submitted to the Development Services DepartmenUCity https://dnr.alaska.gov/welts! within 30 days of well completion. D OR email electronic well logs to y Permit Number: Date of Issue: 1 1 dnr.water.reports(a.alaska.gov Parcel Identification Number: - - 'Guide for Using the Hydrogeologic Classification System for Logging Water Well Boreholes by Thomas M.Hanna NGWA Press COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: 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) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test?Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ 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 Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: Rabbit Creek View & Heights Block 6H, Lot 11A 020-561-48 1.7 8/29/2007 N/A 54 54 .795 >24 Forge Engineering 8/4/17 0* 4/28/20 *Artesian Well. N/A N/A COSA Checklist yellow sheet 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’ Yes if No ft Neighboring Tank > 100’Yes if No ft Absorption Field on Lot > 100’Yes if No 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 From Septic/Holding Tank on Lot to:(Please enter distances if less than required) Building Foundations > 10’Yes if No ft Property Line > 5’Yes if No ft Absorption Field > 5’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 septic tank is under driveway comment below From Absorption Field on Lot to:(Please enter distances if less than required) Building Foundation > 10’Yes if No ft 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 If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft F. ENGINEER’S COMMENTS G. ENGINEER’S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 5/6/2020 N/A ✔ ✔ ✔ N/A ✔ ✔ ✔✔ N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Septic system has yet to be constructed on the lot. ✔ 61 8 9 10 u >> • Municipality of Anch e' `. On-Site Water and Wastewater Pro mEB 0 a 2013 n (907) 343-7904 S AF ET Y Cli CO Certificate of On-Site Systems App = 1 L g�� Parcel I.D. 020-561 -48 Expiration Date: 1H - / 7 1. GENERAL INFORMATION Complete legal description Rabbit Creek V&H, B6H L11 A Location (site address) 16821 Byron Drive Current Property owner(s) Devon Bradley & Melissa Bortone Day phone Mailing address 11826 Wilderness Drive, Anchorage, AK 99516 Real Estate Agent John Wilson Day phone 748-3787 2. TYPE OF DWELLING: H Single Family (w/wo ADU) ❑ Duplex (l Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 1 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well H Individual x Individual Water Storage H Holding Tank n Community Class Well n Community n Public Water System _ Public Sewer E WaiverNariance request for: Distance: Received by: i�``/ M Date: ,1/7/Ig COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 265- Waiver Fee $ Date of Payment , ./Co!(g Date of Payment Receipt Number 0910 TO Receipt Number COSA# OSU? (03( 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. Name of Firm Anderson Engineering Phone 310-9090 Address 1399 W 34th Ave, #203, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, PE Date 1/31/2018 6. DSD SIGNATURE System #1 Approved for System #2 Approved for bedrooms" " • • '. Bzn;.arl Schiller bedrooms �+r;'• CE 12592 �'' I Disapproved Conditional approval for bedrooms, with the following stipulations: -- � �, v�:� �s r.�,ft- � �� ____�"'.� �� �► int TER P 4 WAST B-� `�"" �i Original Certificate Date: 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: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet—S '- w If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Rabbit Creek V&H, B6H L11 A Parcel ID: 020-561 -48 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) N Date completed Unknown Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth ft. Cased to ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test Unknown 8/4/17 Static water level ft. Artesian ft - Well production g.p.m. 1 .7 g.p.m. WATER SAMPLE RESULTS: Coliform ND colonies/100 mL Nitrate 0.549 mg/L Arsenic ND ug/L Date of sample: 7-28-17 Collected by: Anderson Eng B. SEPTIC/HOLDING TANK DATA Tank Type/Material N/A Date installed Tank size gal. Number of Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) Depression over tank (Y/N) High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed N/A Soil rating (g.p.d./ft2 or ft2/bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access(Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots >100' Absorption field on lot N/A On adjacent lots >100' Public sewer main >75' Public sewer manhole/cleanout >100' Sewer/septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in ". . � conformance with MOA COSA guidelines in effect on this date. c*• �,{ *+� Benjamin Schiller •• .. ... ...... Engineer's Printed Name 1/31/2018 Date t • Ben in Schiller Ait :::• C 1292 .'wr/ 1 ,/$94;,;. 1, * t8 •' COSA brown sheet 10-10-12.doc +. GE ENGINEERING PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) February 1,2018 Municipality of Anchorage Development Services Dept- On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage,AK 99507 Subject: Rabbit Creek View & Heights, Block 6H Lot 11A— 16821 Byron Drive COSA conditional approval Dear On-Site Services Engineer: The owner of this property is in the middle of selling it. The property currently has a tiny cabin on it, with an Incinolet toilet for waste disposal. At some point in the past a well was drilled on the lot, apparently without an on-site permit. A copy of the well log is attached. The well does not have a pump installed, and there is no actual septic system on the lot. The last time the ownership of the property changed, it was a cash sale, and it seems nobody realized that they'd needed to get a COSA for the well. We are requesting a conditional COSA for this property. The new owner has agreed to build an septic system for the lot, and will have an approved permit by the end of this calendar year. They recognize that this is an administrative exception to the standard process,and that they will not be allowed to sell this property again before this system is built. Sincerely, Benjamin Schiller, PE 0-k: 49TM A ..*y • =en: Schiller r� �'�'•• 12592 .�/� 14 „Tenpoff,ss�p� 0 — /y-/ThfW p-o(„..2t2 • >-1 0-e 0 712 D °� i!' L f�C•r�e i Her 9A �� 613 �' S14° 35' 00"E 30.00' cb C4) ‘ , 4) ‘F 'It c' KT 'c.-,(%?„h 6-9• 9F S 10'X 20'\ 686, ( ',' N89° 43'47"E 33.96' I LOT 10A CABIN (12.4'X 10.4') SHED-�� 4. • 00 6 Q try CJ3 CV W o A/ LOT 11A to 2 N co W N 16 t�a �b ..>-,::- e o 2 • •. LOT 12A `- N ° 30 ire ( - o cn R-220. r> 7j • 00 ' =43.20 oa000pp� • X80" S89° 43' 53'W 38.68'--t. p o 5�4,. .'.•...-...:',,i.••••••• �50'TEMPORARY �OjQ. '• `�'" '.-/ "O RO�„..:•:.:.•: TURN•ROURY a * / TH /� • *�O Q�,: ''`;_':..;. =220.00' L=54.8 �, iO V ( •4 DO ' • STEVEN CALLAG AN, b co Oe' • LS 12034 A O �P^ ..g/707?�!•?'•ass) NOTE: 4P 4°A. "ession6 oo� THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN �V�pppOoo WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH. ADDRESS: 16821 BYRON DR. ORDERED BY: JOHN WILSON PARCEL#: 020-561-48-000 SURVEY CERTIFICATION:LCG LANTECH,INC HAS CONDUCTED A PHYSICAL SURVEY OF THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO LEGAL DESCRIPTION: AS BUILT ENCROACHMENTS EXIST OTHER THAN NOTED. LOTS 10A, 11A& 12A, BLOCK 6H, EXCLUSIONARY NOTE:IT IS THE OWNERS'RESPONSIBILITY TO DETERMINE THE EXISTENCE OF ANY EASEMENTS,COVENANTS,RESTRICTIONS OR RIGHT-OF-WAY RABBIT CREEK VIEW & RABBIT CREEK HEIGHTS TAKINGS WHICH UNDER NO CRCUMSTANCESDSHOULD ANY DATA EREONBEUSED OR COO NOT APPEAR ON THE RECORDED NSO T UCTION,FOR