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US SURVEY 3042 LT 2B T10N R2E SEC 19
Onsite File US Survey 3042 Lot 2B #075-132-96 OWNER OF LAND: Spinell Homes ADDRESS: LEGAL DESCRIPTION US Survey 3042 Lot 213 DATE: 8-6-20 PERMIT NUMBER: OSP201242 DATE OF ISSUE: 7-16-20 TAX IDENTIFICATION NUMBER 07513296000 is well located at approved permit location: ❑Yes ❑No Method of Drilling: ❑air rotary ❑cable tool Depth of Well: 104' Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 104 feet Liner type Static Water Level: 61 feet Recovery Rate 15 ® gpm ❑ gph Method of Testing Air Well Intake Opening Type: ❑ open end ❑open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: ❑yes Ono Method of Disinfection: Chlorine 50 PPM Comments: WATER QLMJTY TESTING CoNform N e, CoV100mL Mates n1►2L mgtL ' SRL u91L 5,11 t 21 Bore Hole Data Depth From To 0 2 2 4 4 41 41 43 43 67 67 70 70 100 100 104 Casing Stickup Overburden Silty Sand & Gravel Sand Damp Tight Silty Sand & Gravel Silt & Sand Damp Silty Sand & Gravel Sand & Gravel Water 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. "� Gt • ! •� s �M3 •" �o e i n www.suilivanwaterwells.com Pump Installation Well Drilling Permit Number: SW OSP201242 Date of Issue 7-16-20 Parcel Identification Number: 07513296000 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. OF A4 AV co .0 AN 49TH 0 Jeffery A. Gostoldi MF LS -6091 00 Aw 11/30/2020 4W i;o 41P '0rofesslon s%o PLAT NO. 2007-24 0"'URVEY 3042 LOT 2B 15,444 S.F. A16 A xo'/ 141 EXISTING QQi WELL /• S8 �/ GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 2000 E. DOWLING RD., SUITE E ANCHORAGE, ALASKA 99507 PHONE 248-5454 I GRID SE5012 I D i /30/2020 I �ffiq JOB NO. US30422B 32.0. 6.0, 26.0. 0), Q 10. I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE C'5 M15"§ MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water System Permit Permit Number: OSP201242 Work Type: Well Initial Effective Date Expiration Date: Tax Code Number: 07513296000 Site Legal Address: US SURVEY 3042 LT 213T10N R2E SEC 19 G:5012 Site Mailing Address: 465 ALYESKA HWY, Girdwood Owner: TEIXMEN ERIC & Design Engineer: This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy fttl� lleartment 7/16/2020 7/16/2021 Lot Size in Sq Ft: 15444 Total Bedrooms: 3 P Private Well ❑ 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 '9 i� Special Provisions: To close out this permit, please submit the following: EAS. 1. Well log 2. Pump install log 3. Water sample results for total coliform, nitrates and arsenic • Received By: Date: MUNICIPALITY OF ANCHORAGE Development Services Department 4 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 075-132-96-000 Property owner(s) TEIXMEN, ERIC Day phone Mailing address P.O. Box 670, Girdwood, Ak 99587 Site address 465 Alyeska Hwy Legal description (Sub'd., Block & Lot) US SURVEY 3042 LOT 213 T1 ON R2E SEC 19 Legal description (Township, Range & Section) Lot Size 15444 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial ® Single Family (SF) (w/wo AD U) Upgrade ElDuplex (D) ❑ Renewal ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (SignatuRrof property owner or authorized agent) Permit/Rush Fees: 16F, 7 5 0V1 b-/`) Waiver Fees: Date of Payment: ZO Z 0 Date of Payment: Receipt Number: 0 3 $'or_�' Receipt Number: Permit No. _051926121a Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc N d - O E 0a S� <Q O 0 0 o /� IL IL �n_ ROM • Co. n `fol im Ifl W W N Z 8 0 NVSMOl 0 -8d is X�FBxI O ri 7 W O N O F O G 2 F E D — ii7 S �a ' m w z z � a. IL s M g <a Cc Qv m c 7d voi m� N N ffl o m Q %, O A J J K \ m j N a W of om =a N C m C c� a ♦*p~`4!1��. 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OS'00.OY MS•OS it ZZ 'VIS 'Oa 3NIw 101N3�1OH_ a e W I e., ">� "oct >LL / �aix3 GGa GGA t � •I _aq / •Ob \ � ( � ¢� off., _ - I I '- — - - c618'.'Sd'x J i` \ \ .�-,-rte •� � �, j'., j�� I �I?IejFS�l:�o W > =f r aiaarly d 3eu L71kli5vW i sI l iF _ 1 OQ Ford,. _r�LL € HG 1 � 2-C'310FNMN :dAi 10'itlLSA07 (0 13316 3351 315 3351 00 YS 9S 'C15.OS'Sf•YI -TIS 3 i- -__ -3�SI— •l, i iz O w� O W� i -I ��.- 1 1� • � 4 �P ; �'�N cad' i S s �� VIII O ,_ gO � 5� i ' 0�w 1 I ; I 17-3lOFiit'W �V 3dA1 L'1fW15N07 i 00'01 II PLS - • H 1 t ! a p CiS5ei3 MUNUPAUTY OF ANCHORAGE 0 r Development Services Department Phone: 907-343-7904 On -Site Water a Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 075-132-96 1. GENERAL INFORMATION 30ga Complete legal description US Surveys L213 Location (site address) 465 Alyeska Hwy Current property owner(s) Spinell Homes Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Expiration Date: , x2 i Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer 0 'ITaiver requestfor: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ / `T O_ (t2Lj_sjj Date of Payment Jt' 12 6 ,9- 0'� I Receipt Number 78 306 COSA # OS C -111 T � a Waiver Fee $ 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. 1 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Date 2 C�vLSr OF• A�,gAkktt 6. DSD SIGNATURE �H, . • . System #1 Approved for ''n' bedrooms Steven R. Pannor e System #2 Approved for bedrooms`''%F�: Disapproved' Conditional approval for bedrooms, with the following stipulations: SPS `'Ghp,M c� Cb ENT }S���l��,� By —aub\ &JUB Original Certificate Date: 5,6 (Oo2 j 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 Checklist blue sheet 3092. Legal Description: US Survey 3L2B Parcel ID: 075-132-96 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)_ ,,,rAfl `DVell production at time of test 15 gpm Date drilled 116120 .- s' l� yj Water storage tank volume na gallons Total depth 104 ft Well disinfected for coliform test? ❑✓ Yes ❑ No Cased to 104 ft ❑Q Coliform bacteria is Negative 01 Sanitary seal is functioning correctly Nitrate mg/L FE -1 Nitrate less than MRL (ND) M Wires are properly protected Arsenic ug/L © Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by PES Date of flow test for COSA new Date of Sample Static water level at beginning of test 61 ft. Comments B. TANK DATA Age of tanks) ye Tank type/materia Measured rating fluid level in septic tank ❑ ndpipes/foundation cleanout per record drawing Date 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 min) ❑ N/A — pressurized field Monitor tubes go to bottom of eff ive. If not, state depth into effective ❑ Code -required soil co over field ❑ System presoa (Required if va t for greater than 30 days prior to date of test Gall s introduced gallons Co ents/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date ults O 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 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) ❑ Yes Septic Tank/Lift Station on Lot > 100' ft If absorption field is under driveway comment below Community Sewer Manhole/Clean . ut > 100' J Yes if No ft gYes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' [ Yes if No ft Holding Tank > 100' M Yes if No ft Neighboring Absorption Fields > 100' ft Animal Containment > 50' ❑✓. Yes if No ft n Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' p/Yes if No ft Q 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' ® Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Water Service 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 driveway comment below Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that / 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. Z to S-a-s-- COSA Checklist yellow sheet