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Home My WebLink AboutUS SURVEY 3042 LT 88D T10N R2E SEC 19Onsite File US Survey 3042 Lot 88D #075-132-41 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING, LAND & WATER Alaska Hydrologic Survey WATER WELL LOG Revised 08/18/2016 Drilling Started: ____/____/______ Completed: ____/____/_______ Pump Install: ____/____/_______ City/Borough Subdivision Block Lot Property Owner Name & Address Well location: Latitude Longitude Meridian ____________ Township ______ Range _______ Section _______ , _____ 1/4 of _____ 1/4 of _____ 1/4 of _____ 1/4 BOREHOLE DATA: (from ground surface) Suggest T.M. Hanna’s hydrogeologic classification system* https://my.ngwa.org/NC__Product?id=a185000000BYub3AAD Depth From To Drilling method:  Air rotary,  Cable tool,  Other Well use:  Public supply,  Domestic,  Reinjection,  Hydrofracking  Commercial,  Observation/Monitoring,  Test/Exploratory,  Cooling,  Irrigation/Agriculture,  Grounding,  Recharge/Aquifer Storage,  Heating,  Geothermal Exploration,  Other Fluids used: Depth of hole: __________ ft Casing stickup: ___________ft Casing type: __________ Casing thickness: _________ inches Casing diameter: _________ inches Casing depth: __________ ft Liner type: _________ Depth: _____ ft Diameter: _____inches Note: Well intake opening type:  Open end,  Open hole, Other Screen type: _________, Screen mesh size: ____________ Screen start: ________ ft, Screen stop:________ ft, Perforated  Yes  No Perforation description: Perf from: ________ ft, Perf to: _______ft, Perf from: ________ ft, Perf to: ________ ft Gravel packed  Yes  No Gravel start: ______ ft , Gravel stop:______ ft Note: Static water (from top of casing): _______ ft on____/____/_____ Artesian well  Pumping level & yield: ______ feet after _____ hours at _____ gpm Method of testing:__________________________________________ Development method:______________ Duration: ____________ Recovery rate: _________ gpm Grout type: _________________ Volume __________________ Depth: From ___________________ft, To ___________________ft Final pump intake depth: __________ ft Model: _______________ Pump size: _____________ hp Brand name: __________________ Include description or sketch of well location (include road names, buildings, etc.): Was well disinfected upon completion?  Yes  No Method of disinfection: Was water quality tested?  Yes  No Water quality parameters tested: Well driller name: .................................................................................. Company name: ................................................................................... Mailing address: .................................................................................... City: __________________________ State: AK Zip: ___________ Phone number: (________) ________- ______ Driller’s signature: Date: ______/______/_________ Anchorage Municipal Code 15.55.060(I) and North Pole Ordinance 13.32.030(D) require that a copy of this well log be submitted to the Development Services Department/City within 30 days of well completion. City Permit Number: _____________________________ Date of Issue: _____/____/_________ Parcel Identification Number: ______-_______-________ *Guide for Using the Hydrogeologic Classification System for Logging Water Well Boreholes by Thomas M. Hanna NGWA Press AS 41.08.020(b)(4) and AAC 11 AAC 93.140(a) require that a copy of the well log be submitted to the Department of Natural Resources within 45 days of well completion. Well logs may be submitted using the online well log reporting system available at: https://dnr.alaska.gov/welts/ OR email electronic well logs to dnr.water.reports@alaska.gov North 15 PO Box 110378 WAYNE WESTBERG BOB TYSON , AK M-W DRILLING 10.0 36.0 78.0 002E 0.0 1.0 6.0 88D 907 47 8436.0 10.0 6.0 1.0 6 n 85.0 78.0 5 19 1978 n SANDY WATER GRAVEL SILTY GRAVEL LOOSE GRAVEL ORGANICS CLAY FILL 85 38310 345 4000 GIRDWOOD NONE 2 n ANCHORAGE n 99511 10 S 010N MUNICIPALITY OF ANCHORAGE A Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 075-132-41 Certificate of On -Site Systems Approval Expiration Date: 'Zo Z Legal description US SURVEY 3042 LT 88D T1 ON R2E SEC 19 Site address 225 Sproat Rd Girdwood Current property owner(s) Brian and Debra Hicks 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: 3/1/2023 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 Tank Age Advisory Arsenic Advisory Other COSA ApprovaLiune 2022 MUNICIPALITY 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. 075-132-41 Complete legal description US Survey 3042, Lot 88D, T1 ON R2E Section 19 Location (site address) 225 Sproat Rd, Girdwood, Alaska, 99587 Current property owner(s) Brian & Debra Hicks 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: X Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage Age N/A - See advisory if steel older than 20 years . A ' - 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 $_ oC 20 Date of Payment a/a I l o -V) a 3 COSA# Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 US Survey 3042 Lot 88D T10N R2E Section 19 075-132-41 3.6 87 86 0.702 18+ 2/13/23 Forge Engineering 74.1 2/13/23 N/A N/A N/A > Benjamin Schiller, P.E.2/16/23 N/A N/A N/A N/A N/A N/A (907) 522-7773 • Municipality of Anchorage On -Site Water and Wastewater Program x' E (907) 343-7904 s�� ET Y Parcel I.D. 075-132-41 Certificate of On -Site Systems Approval Expiration Date: to - If (O - 1. GENERAL INFORMATION: Complete legal description USS 3042; Lot 88D Location (site address) 225 Sproat Rd. *Girdwood, AK 99587 Current Property owner(s) Michael Fleming Day phone 9524179 Mailing address 225 Sproat Rd. *Girdwood, AK 99587 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: 3 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: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ oC 1 b I - I 0� Waiver Fee $ Date of Payment Receipt Number 009 2. q% G COSA# osCa 613 1 1 C Date of Payment Receipt Number 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: Garnes_s_Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: `:F In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the datels of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the fo ~ _ ........... .......... ......... . ......... ......... •p CE #AECC884 4ATYt0p((��/�(�i - "yam% IS oN-SITE WATER AND i tipu�0 Tm IT, 2 1111J)))))11111\ Original Certificate Date:'"/ 4— 2 0 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet-10-10-12.doc COSA Checklist Legal Description: USS 3042; Lot 88D Parcel ID: 075-132-41 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 5'15/78 Total depth 87 ft Cased to 86 ft ❑ Sanitary seal is functioning correctly ❑Q Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 6'14i20 Static water level at beginning of test 72.2 ft. Comments B. TANK DATA Age of tank(s) years Tank type/material Measured operatin ld levet in septic tank ❑ Stan ' es/foundation cleanout per record drawing ate of pumping 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, stat depth into effective ❑ Code -required soil cover over fiel ❑ System presoaked (Required if vacant greater than 30 days prior to date of test) introduced gallons 'Deficiencies: COSA Checklist yellow sheet Well production at time of test 6.0+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 0.5ISmg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L u Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 6/14120 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments - Adequacy test date Results ❑Pass For bedrooms Fluid de::�d� prior st in Water gal ew depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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' N/A Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft Cj Yes if No ft Neighboring Tank > 100' C] Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No N/`4 ft Holding Tank > 100' 0 Yes if No * ft Neighboring Absorption Fields > 100' * Animal Containment > 50' Yes if No ft M Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q 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 Surface Water> 100' ❑ if No ft Property Line > 5' ❑ Yes if No ft Wells onLogfit ts: Absorption Field > 5' ❑ Yes if No Private Wells > 100' ❑ Yes if No. Water Main > 10' es if No ft Community Wells > 200' ❑ Yes if No. Wat ce Line > 10' ❑ 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 If absorption field is under driv cap mment below Property Line > 10' ❑ Yes if No ft Wells ool nt Lots.- Water ots:Water Main > 10' ❑ Yes if No G—ft� Private Wells > 100' ❑ Yes if No Water Service Line > 10' es if No ft Community Wells > 200' ❑ Yes if No Su ater > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS `Per tax records there is no home on Lot 88E. MOA On -Site records research indicates there is no water and/or sewer serving the lot. In short, it is assumed that the lot is vacant and has no utilities. G. ENGINEER'S CERTIFICATION l certify that 1 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. COSA Checklist yellow sheet O F AE" an I.................. .J ff A. Carness., Q 1cE=- Q`9s •••. >-�1••• •BOG o�ot� �.�•11� •t �� o r e s sioRo�o #AECC884 ft ft ft ft i1 1 ; , 0 i ;ti , - 0 L 0,v .f J Y```�11J /,51 . - . 01 2- Story Hous 15 30 US SURVEY FEET OF• A/ ;K*.- 49TH Ro4 X jC-(6 Y LS-117�16 NOTES �Vll dimensions shown are s, 49th Star has conducted ' grid hearings and gL'Outid di ta ce, record boundaries are pet P!ar No. 69-239. s should all\,* data hereon be u . il-CLIMStance, 1)hys'crtl curvet' Or the PI-OPe"ty and all cl(tafls shown oil this Asbuilt Survev are correc, Under no �SPQT`lsibflit�� to determine the e}Ljste� cc t is the Owners "c used for c"Strucri0r, or the escablisil-mellt of property Lftles e s trictions rox� 3 feet of Snow- wils present at tillie of survey; 4901, titan is not responsible For ; no title research Performed. \p1m n OraM, eascinents, covenants, or I- lrove'lle'lls Pl*e'-zcPt thal: were not visible. I'lle Primary arc' Secondaxy Building, setback lines are its per NIOA "Verification of Noticonfornjilla StaLljs,, letter for this property, ated 4/16/1-)(7). AS BUTUr ST—TRVEY LEGEND Lot 88D, well 321 Fireoved Drive- Anchor^age, AK 99508 US Survey No. 3 042 Utility Pole (907)891-6111 Girdwood, Alaska Electric Meter Jeremy@49thStarSurveying.cont Gas Metel. DATE: SCALE: 1 "=30' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0-7y- J3a 1j I HAA#. 1. GENERAL INFORMATION Complete legal description Lot 88D; U. S. Survey 3042 Le, L tom-. Location (site address or directions) Property owner 'Brett Baker - Mailing address Box 1192 % Lending agency - ": 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Phone to q q 17034 Eagle River Loop Road No. 204 Address Eagle River, Alaska 99577 / ' Engineer's signature — 6. Df-ItiS SIGNATURE X Approved for C_?) bedrooms. Disapproved. Conditional approval for Date_ �Lr X7c q % ROBERT C. COWAN s CE - 8801 �► a� bedrooms, with the following stipulations: Additional Comments By:,, Date The_ Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professionalengineerregistered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M(Rev.1/91) Back MOA#21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES A"66Q�talEnvironmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 •C1'�'3-�T# GN IRON ENTAL SERVICES DIVISION Health Authority Approval Checklist E— LE , - Q ,- ,' is . Legal Description: `�' �' 7 V .. S _ Yd itJ� 3� ti 2 Parcel 1. D.: '7S- -, / , . " —f Ln . V LE) A. WELL DATA Well type /�" Y `�' `� If A, B, or C, attach ADEC letter. ADEC water system number Log present (YkIN)P r" O Date completed Total depth 7 y 4 Cased to � a 4- Casing height (above ground) f f Sanitary seal O/N) Y ¢ S Date of test FROM WELL LOG VIk Static water level U 1 14 Well production WATER SAMPLE RESULTS: Coliform 0 V/K Date of sample: )- f �-c r/ `1 B. SEPTIC/HOLDING TANK DATA Date installed Nitrate /PVJL,C Wires properly protected O/N) 'y & S AT INSPECTION c/ 7 -7 `f f g.p.m. -7.Yg.p.m. �4li/lCig1J QY (��.tif i�� t�i1. • S / S— Other bacteria 0 Collected by: S & S ENGINEERING 17034 Eagle River Loop Road Wo. 204 Ecigia River, Alaska 99577 Tank size Number of Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) Date of Pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ft2/bdrm System type Length. Width Gravel thick s below pipe Total depth Effective absorption area Monitorin ube present (Y/N) Depression over field (Y/N) Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption fie efore test (in.); Immediately after gal. water added (in.): Fluid depth (ins) Minutes later: Absorption rate = g.p.d. Peroxid eatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* *Datum "Pump off" level at* Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot N /A On adjacent lots Absorption field on lot N 114 On adjacent lots Public sewer main -7 T , f Public sewer manhole/cleanout Sewer /septic service line Sr 4 Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Property line Absorption field Water main/service line Surface water/drainage n adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIEL LOTTO: Property line Bui foundation Water main/service line Surface water Driveway, parking/vehicle storage area Cu�iR rain Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that 1 have determined thru field inspections and review of Municipal in conformance w' h M0A,1JAA guidelines in effect on this date. Signature � �� - �'-;�'L• �-- Engineer's Name a 3 • z % C_ ce Date 3 71 n HAA Fee $ J G` Waiver Fee $ Date of Payment„ % Date of Payment r Receipt Number��-� 1-� t� =�� 1�' Receipt Number 72-026 (Rev. 3/96)* o J ROBERT C. COWAN t �t x 4, CE -8801 are