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Home My WebLink AboutPARKER LT 2Jun 21 22 09:41 p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services Department l 4` Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Parcel Identification Number: 008 031 19 Legal Description Block I Lot PARKER 1 1 2 Pump Installation Date: cs - 14 - 2022 Pump Intake Depth Below Top of Well Casing: Pump Manufacturer's Name: Pump Model: Pump Size: •50 AYMCDONALD 23050V3LB Pitless Adapter Burial Depth Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: feet Date of Issue: - Property Owner Name & Address: COTTRELL JAMES IV & DENISE 10100 CURVI STREET ANCHORAGE, AK 99507 feet UNKNOWN TYPEMRAND Well Disinfected Upon Completion? k Yes ❑ No Method of Disinfection: PELLETS Comments.- Pump omments: Pump Installer Name: Company: Mailing Address: ANCHORAGE WELL & PUMP SERVICE 7540 KING STREET ANCHORAGE, AK99SIS 9D7-243-0740 State: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Jul 08 ^ 901:16P Anoht:):@gP, Well & Pump Ser 9-072430742 P,1 bevelopinent Services department -1 wv[sion BuMing Safet 011-SiTe Water- & iN,,.Stewater pr,Oqv:%M 4700 El.more Street P.O, Pax 196650 A K 9 9 5 Anchorae, 13 5, 6_7,a Mayor wqna_� 343 1.04 Pump Installation Log 'Well Drilling Permit Number - Parcel Iden title' a rion. Number: Legal Descripfiar, Mock Lot PO,r 12 Pump Installation Date: Date rd Iss-ov: -7 Pr onr--rry O -wrier Narne & Ad -dress; Ly PL'r-'1P Eltla 'CC I)CPth BOM TOEk Of WL11 Casino: Seel PUMP Maaufilctvrer's, Paine_ PuMpModd: Pump'size hp Pidess Adapter Burial Depth: feet Pitless Adapter manufac!Turerls Name: Phless Adapter i1 stalltr: I Well 11sinfecte)Pon Completion? Li ye.s -- I d L N10 Method of Disinfection: Comments: Plamp histaller Name - Company: -ailing Address. City;Saacecdip:41 ry Attention: 71,e lyi2rlp ir, Stall lie r SkOl pTovid-. E PlInIP installation tog to "T?S D �� iql' a,c, ,jay: • .. • PGE.. •y •, �t� Municipality of Anchorage rQ On-Site Water and Wastewater Program •��' (907) 343-7904 $A ETY CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 008-031-19 Expiration Date: e 1. GENERAL INFORMATION Complete legal description PARKER LOT 2 Location (site address) 4241 WRIGHT STREET,ANCHORAGE,AK Current Property owner(s) ESTATE OF ROY ONDOLA Day phone Mailing address 16250 E SMITH ROAD,PALMER,AK 99645 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class_Well ❑ Community ❑ Public Water System ❑ Public Sewer WaiverNariance request for: Distance: Received by: Date: q i0//g COSA to be release. • r- - gineer,unless otherwise requested by the engineer. COSA Fee $ _ Waiver Fee $ Date of Payment d1 foil,1/!r (�K IO22 Date of Payment Receipt Number 2.a,a b Receipt Number COSA# 06C-LD1'1 I 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 CONSTRUCTION & ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516 Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 09/25/2018 6. DSD SIGNATURE `s System #1 Approved for Z--bedrooms. e• ^•° <; 9...,�I r °°°°° + ' : A4ICl AE( N. f• I:GERS h� e�•':�' System #2 Approved for bedrooms. ei��•• C[-9469 1 Disapproved. <�I •.Gj Conditional approval for bedrooms, with the following stipula`tidri ,- -mow l Lu s fig 4? • By: `^ -(` Original Certificate Date: q" 10 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 .. .,.. , t,, Well Flow Advisory Other' COSA blue sheet_10-10-12.doc 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: PARKER LOT 2 Parcel ID: 008-031-19 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 41+ ft. (Per soundings) Cased to 40'+ ft. (Per NO3 Results) Casing height (above ground) "6+ in. FROM WELL LOG AT INSPECTION Date of test •- 9/21/2018 Static water level •• ft. 22 ft. Well production g.p.m. 2 g.p.m. WATER SAMPLE RESULTS: Coliform AJE4 colonies/100 mL Nitrate NC' mg/L Arsenic: N D ug/L Date of sample: . 9/14/18 Collected by: First Water Consulting Services B. SEPTIC/HOLDING TANK DATA—NA PUBLIC SEWER Tank Type/Material 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 - NA PUBLIC SEWER Date installed 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 NA On adjacent lots NA 100'+ *(50'+) Absorption field on lot NA On adjacent lots NA 100'+ *(50'+) Public sewer main #754. *(504) Public sewer manhole/cleanout 1094 *(50'+) Sewer/septic service line )6''+ INA/Unkn) Holding tank 200'+ *INA/Unkn� Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: - NA PUBLIC SEWER Building foundation Property line Absorption field____ Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: - NA PUBLIC SEWER Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS *Met separation requirements at time well was drilled CIRCA 1958. **Well is locate d below grade in crawl space with floor drain- photos reviewed with MOA staff. G. ENGINEER'S CERTIFICATION d� OF Az '- I certify that I have determined through field inspections and • 'r' review of Municipal records that the above systems are in ,'> ^49TH ‘110 conformance with MOA COSA guidelines in effect on this date. ..c:..�•• Tf , Engineer's Printed Name MICHAEL N.ANDERSON,PE r�� MICHAEL N.'ANDERSON ;� • C Date 09/25118 (4 ,•q 7 tt 9� ``',p l�� COSA canary sheet_2-6-15.doc WRIGHT STREET _ _ CA CA. �-+ ' � I T N00'06'00"W 50.00' — N N W 7.0' CO CECK p, p, • o 0 9.0' 8.0' iit 7.3' x YELL rn < = X < N 0 N CO in C.l Z oa. co Go rn 0 cn co < v CI (] C31 (0 I fT1 24.0' In < DECK 7.5' I a 4< LOT 1 LOT 3 1 X IGRAVEL X 0/W W W I 1\ LOT 2 N I X 1 X I X •8 9.8' Ito x I rn ix 0 s.0' Y _ <—X—X—X—X—X—X—Xy N00'06'00"W 50.00' CA PARKER PLACE ANCHORAGE RECORDING DISTRICT,AILASKA 1 AS-BUILT OF: PARKER SUBDIVISION =FND 5/8"REBAR LOT 2 PLAT P-310 ``"k SURVEY CERTIFICATE:I,John L.Schuller,Have conducted a 0 F AAN% 11D S L Rphysical survey of this property as shown on this drawing and that the % .• •. £;o11. 6'e4,;.> ��'f� improvements situated hereon are within the property lines and no C,,.•' rf•' enchroachments exist other than noted.Under no circumstance should *.' 49TH �y*, ,tea () any information on this drawing be used for construction of fences, /% /• � tt, �, r' structures,improvements,or for establishing boundary lines. EXCLUSION NOTES:It is the owners responsibility to determine 0 •p til �fi P. R' C) •. HN L. SCHULLER. °/ = the existence of any easements,covenants,or restrictions which / p. �•1,A0 Tri LS-10408 • do not appear on the recorded subdivision plat. 1�r 'O '�-� --8" WORK ORDER NUMBER: DATE SCALE: E-wui: '1 P o SJ�� 1831 Anchorage,TalkAlaskaetna Street SEPT 19, 2018 1"=20' ,`°p - 9r1 S. na i 99508 18-060 DRAM WA CHECKEDB'"OPo NUMBOk DOCK/PAGE: \\r°fessiono1 �.°r�r (907) 227-1455 office JLS SW1734 180224 �\�� (907) 274-4992 fax