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Home My WebLink AboutMOUNTAIN VIEW BLK 7 LT 4 S2 W3 N2 Onsite File Mountain View Block 7 Lot 4 52 W3 N2 #004 - 031 - 38 Certified Drilling Log DOC CO dba BILL 8c COLE 11111 U LLIVAN WATER WELLS ki 4 P.O. Box 670269, Chugiak,AK 99567 688-2759 OWNER OF LAND: Habitat For Humanity-Anchorage Bore Hole Data ADDRESS: 223 Taylor St. Depth LEGAL DESCRIPTION Mountain View Block 7 Lot 4 Sa t33N2 From To DATE: 7-13-18 0 2 Casing Stickup PERMIT NUMBER: OSP181048 DATE OF ISSUE: 4-16-18 TAX IDENTIFICATION NUMBER 00403138000 2 4 Overburden Is well located at approved permit location: MYes []No 4 48 Tight Silty Sand & Gravel Method of Drilling: Nair rotary cable tool 48 89 Silty Sand &Gravel w/Clay Depth of Well: 162' 89 101 Silty Sand & Gravel Water Casing Type: Steel Wall thickness .250 inches 101 124 Silty Sand &Gravel w/Clay Diameter: 6 inches, depth 162 feet Liner type 124 157 Silty Water Gravel Static Water Level: 39 feet 157 162 Sand & Gravel Water Recovery Rate 15 N gpm gph • Method of Testing Air Well Intake Opening Type: N open end open hole n Screened Start feet Stopped n Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth:from 2 feet,to 42 feet Well Disinfected Upon Completion: yes n no Method of Disinfection: Chlorine 50 PPM Comments: WATER QUALITY TESTING 1 CoiUowrn N e� Co1/100mL Nitrates N D mg/i Arsenic N n ug/1- %/11l18 Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. DOC CO dba 1DLL111AEN WATER WELLS 't 4.' P.O. Box 670269,Chugiak,AK 99567 688-2759 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP181048 Date of Issue 4-16-18 Parcel Identification Number: 00403138000 Legal Description Property Owner Name &Address Mountain View Block 7 Lot 4 S 2. Lk)3 N 2. Habitat for Humanity Pump Installation Date: 7-17-18 Pump Intake Depth Below Top of Well Casing: 90 feet Pump manufacturer's Name: F&W Pump Model: 4F11P05301S Pump Size: 1/2 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Sullivan Water Wells Disinfected Upon Completion? ® yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson Pump Installers Name: Sullivan Water Wells Attention:The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. SG$ . SGS Ref.# 1184588001 Client Name Pannone Eng. Srv. Printed Date/Time 08/30/2018 16:44 Project Name/# 223 Taylor St. Collected Date/Time 08/17/2018 13:40 Client Sample ID 223 Taylor St Received Date/Time 08/17/2018 14:03 Matrix Drinking Water Technical Director Stephen C.Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 08/20/18 08/29/18 DSH Waters Department Total Nitrate/Nitrite-N ND 0.100 mg/L SM21 4500NO3-F B (<10) 08/21/18 AYC Microbiology Laboratory E.Coli Negative 1 100mL SM21 9223B A 08/17/18 K.W Total Coliform Negative 1 100mL SM21 9223B A 08/17/18 K.W -Q---------- z OQ z V) < Ld CD C) z z P WV) 9 x Lr) Li E5 Y7 "'S"s 0 Or lzp ss ss s S!, z In (D LLJ -- —LI-jCrJ — — —C SD —SD —SD —S 9s]) C-) SD LLJ-SD—SD—SD—SD- -W ti r- 06 U) 0 Z < z Zt V) 06 0:7c LLJ 6 CC) C) It F- D Ld z LLJ W: — z 00 :0:) Vo) LLJ' F— f M U) ) + LIJ TAYLOR ST Z _j U) 0 Lcs u i > z m (n 0 0 Z Z > Z + 0 uj :D Z UJ M W 0: m CL N Q - Z it 0- (D % w -i Li L- I (nr C�T Ld uzj, 00 M 0 + > +0 Z CN 0- r Li C; D- Ld CD C) z z P WV) 9 x Lr) Li E5 Lo&o 0 �pQ CD Z C) b LLJ 04 qQ U.J LLJ Cq XZ M Z 0 rn —,0 CN V) >-i 0 0 V) z 0) Y7 0 Or z In (D LLJ -- —LI-jCrJ — — —C SD SI) SD 9s]) C-) SD LLJ-SD—SD—SD—SD- 0 CD 0 0 0 x X -9 u"' E oD 0 C14 < C) LLJ 6 CC) W Ld z LLJ z LLJ f M U) ) + LIJ TAYLOR ST M tr) m m 0 a C,4 C%j 0 CD in 10 0) 0 0 o - r, r, 0 CL N Q - 0 s- tocoococ r- 0) 0 (D o CL -i Li L- I LLI C�T -CI4 z -T- CN Z CN r Li C; D- 't N a- m a: cj 0) 0 + + + 0- C,j It 0 cq NI I Lo&o 0 �pQ CD Z C) b LLJ 04 qQ U.J LLJ Cq XZ M Z 0 rn —,0 CN V) >-i 0 0 V) z 0) Y7 0 > (D LLJ < ly) 0 CD 0 0 0 x X -9 u"' E oD < 0 win 'o, 0 NO -a 0 in 0 N C4 00 (D 0 a C,4 C%j 0 CD in 10 0) 0 0 o - r, r, 0 CL c 0 s- tocoococ r- 0) 0 (D o CL < °:0 L- I CL to, " .— ICIPALITY OF ANCHORAGE �ti,l i I7 -. �, �J �\ On-Site POBox Water196650 470&Wastew0ater Elmore ProgrRoadam �, j 5�;, ; ' ". ..� Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 .;r r. ;' / httpa/www.muni.org/onsite WA yy /' 1).•Iwrtmcnt 44' ;,-(;R-NO On-Site Water System Permit Permit Number: OSP181048 Effective Date: 4/16/2018 Work Type: Well Initial Expiration Date: 4/16/2019 Tax Code Number: 00403138000 Site Legal Address: MOUNTAIN VIEW BLK 7 LT 4 S2 W3 N2 G:1135 Site Mailing Address: 223 TAYLOR ST, Anchorage Owner: HABITAT FOR HUMANITY-ANCHORAGE Lot Size in Sq Ft: 3375 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy El Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: To close this permit please submit: 1. Well Log 2. Pump Install Log 3. Water sample results I ' /-f Received By: �, ,► ��.�II•%� l.i / ..._.......1 Date -q7/11A Issued By: fl ;_ / Date: (-1/C/ MUNICIPALITY OF ANCHORAGE Community Development Department law Phone: 907-34 Development Services Division ~- Fax: 907 1 On-Site Water&Wastewater Program ' •;' ? o i ON-SITE SEWER/WELL PERMIT APPLICATION a AF'R 0 9A14.„ > Parcel I.D. 004-031-38 c �w Property owner(s) HABITAT FOR HUMANITY - ANCHORAGE Day phone /I a6 9 9 Mailing address 1057 W FIREWEED LN, STE 103, ANCHORAGE AK 99503 Site address 223 TAYLOR ST. Legal description (Sub'd., Block & Lot) MOUNTAIN VIEW B7 L4 S2W3N2 Legal description (Township, Range & Section) Lot Size 3,375 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (El all that apply) Absorption Field ❑ Initial Single Family (SF) 0 (w/wo ADU) Septic Tank ❑ Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑X Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 4IP 1440p 41116 Signature of property owner or authorized agent) Permit/Rush Fees: oZ 1 45- Waiver Fees: Date of Payment: 1—all Date of Payment: Receipt Number: (.5 -2._g a Receipt Number: Permit No. ()S* \O -k8 Waiver No. Permit App_ ::..,.c Pannone Engineering Services LIc Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@panengak.com 5 April 2018 Subject: MOUNTAIN VIEW 137 L4 S2W3N2 Private Well Permit Request Design Narrative This is a design narrative for a permit to install an initial well to be issued for this property. The proposed well will serve a proposed three bedroom (3) bedroom house. Currently the lot is being developed by Habitat for Humanity and will be served by public sewer service. This lot will be served by a private well. The surrounding developed lots are served by public water service. There are no septic systems within 100' of the proposed well. 1. Well Location. a. See Sheet 1 of the design package. 2. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On-Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 I 1 1 ` H N IE 'k Akikw 0 N TRUE NORTH SCALE 1"= 50' C II 1 N - (!C °In Q Ilm 00 1_ .__I 1 cl) I _ -OHE OHE OHE OHE OHE —OHE OHE •4''• OHE OHE OHE— °fir 8" H2O '!'! '��i.�l - -- 1�'�l 8" H2O 'i. m Q�i,� _�,8 CMP SDI PETERKIN 00,0 14+00.0 +00.' 12+00.0 —SS —SS [a" C900 PVC SS —SS —SS —SS S. , y S. Q —SS —SS 8" CP SS SS SS —SS SS — x.7.6-4- ,-- GAS—GAS—GAS—GAS—GAS—GAS GA - —GAS n i.1 SURROUNDING LOTS SERVED BY `" PUBLIC WATER AND SEWER C) I, cr) o r 1 111 1 1MH \ 1 I SFD(P) 7! II 1 * 1 1 28.5 I1 \ � N c m I — i FG] Util Esnr, I I i INSTALL WELL P **MAINTAIN A MINIMUvI OF 25' SEPARATION FROM PRIVATE SEWER LINE 1A m (AMC 15.55.060,B,TABLE A-1) & 10' SEPARATION FROM OVERHEAD POWER I 81 Air Space LY. A I LINES / m 4 W _ W 1 I I j NOTES: PANNONE ENG SVC, LLC. OF Dote 05/2018 FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 !' '• PHONE (907) 272-8218 FAX (907) 272-8211 1oo/_'• Scole *149 11 .. ; MUNICIPALITY OF ANCHORAGE Development Services Department�a� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 004-031-38 1. GENERAL INFORMATION Expiration Date: 130 2Z Complete legal description MOUNTAIN VIEW BLOCK 7, LOT 4 S2 W3 N2 Location (site address) 223 TAYLOR STREET, ANCHORAGE, AK 99503 Current property owner(s) HABITAT FOR HUMANITY -ANCHORAGE Day phone Mailing address Real estate agent 900 E BENSON BLVD., ANCHORAGE, AK 99508 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer Waiver request for: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ a Date of Payment 11 2 021 Receipt Number S 1 y 211 COSA # O S C 211 �'a a Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 11/2212021 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 estimate of how long a system will function satisfactory .. .'f,9 for current or future occupants or guarantee that no unseen encroachments, deficiencies or �J discrepancies exist can be given by First Water Consulting & FWCS ' *'.� lli .......* r� 6. DSD SIGNATURE /// .:• • Curtis Huffman C� System #1 Approved for bedrooms Curti; 'Huff ..,��r� �IiF�F�PROF S510�P�'��'r System #2 Approved for bedrooms 11\ OFESSO� Disapproved Conditional approval for bedrooms, with the following stipulations: By:Le� Original Certificate Date: /� 2 The Municipality of Anch/geevelopment 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 Checklist Legal Description: MOUNTAIN VIEW BLOCK 7, LOT 4 S2 W3 N2 Parcel ID: 004-031-38 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 7/13/2018 Total depth 162 ft Cased to 162 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 9/21/2021 Static water level at beginning of test 24 ft. Well production at time of test 6.5+ gpm Water storage tank volume NA 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 9/21/2021 Comments B. TANK DATA - NA 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 - NA 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: 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 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 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 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. 11/23/21