HomeMy WebLinkAboutBELLA VISTA #1 LT 24LL
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MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
Alpine Drilling-& Enterprises
PerWt NOmber: #SW�2314-11 )Date of Imue: 124 B-23 Par6ellIdentificationNimber., 013113
Date Sftr"i 2-10-24 Date conpletedz' ki Is well lo=W at approved pernift location? n Yes Q No
lksi€Otion: Belfe Vista #1 Lot 24
Property Ovvuer Name & Addrm; BROn & Kandy. Brodenck
Borehole Depth (U)
Soil TYM Tmelmess & water ShUoL Froin To
Mcth*doIDdHWg xair wtaly [] cable tDOI
Casing qOie*
jKlast4,16 lath WCU acrd 3'xulo well Pit 0 52
Wall I'likkness: imcfies
s90 gi-avd B20 52 55
Diameter. inches Depth: feet
Liner Type; steel
Diameter. 4 inches Depft 55%t
Cas laz silckup above ground: L-5 feet
Static water level (from gmuud level)- jj_fi�d
Pumping levek_,52 feet after
4140un pumping -3.5 gpm
Recovery Pate: 3.5 gpm
Metliod oif Testing: pyw
wen hdalm opening Type --
x Open Rid Open Role
0 Screened Stqxt fbet S6ped feet
El Pekfbrations Saari feet 96pped feet
Grout Type:. Bentonite volume; 1ha
. . . . . .
Start labd &0
apqd 152 feet
Pump: Intake Depth feet
PP size: hp Rand Name
Well Disinfected Upon Com*tion? -x Yes No
Method of Disinfection: ahlorm' L aft&
Comments: 4 inch was hatalledinside m*ftwell pit
and 6 - inch c=i'ng. GrovtedfromJO't65Z Bentonite
chips to be.addedabave 10jegtwhen wawfino is
installed qd_pit is decommisioned
WORDAUer: A47bw Drilling & Ewerpr&av
PO Box 110495
Anchorage AK9951-1
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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://wvvw.muni.org/onsite
On -Site Water System Permit
Permit Number: OSP231411
Work Type: Well Upgrade
Tax Code Number: 01305136000
Site Legal Address: BELLA VISTA #1 LT 24 G:2231
Site Mailing Address: 713 E 79th AVE, Anchorage
Owner: BRODERICK BRIAN & KANDY
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
Effective Date:
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
1 ll1 C Il j s.,
Ptt]1P_tlt
12/18/2023
12/17/2024
43200
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy 0 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
Special Provisions:
To close this permit please submit:
1. Well Log
2. Pump Install Log
3. Water sample results
4. Well Decommissioning Log
Rehr: _ _.1 S 9LAfA kC, L;E6'
Issued By:
Date:
Date: _/ Z.,11 gr, 23
2
Development Services Department Phone: 907-343-7904
On Site Water & Wastewater Section '" F907-343-7997
ax.
ON-SITE SEPTICIWELL PERMIT APPLICATION
Parcel I.D. 013-051-36
Property owner(s) C/O BRIAN BRODERICK
Mailing address 725 E
Site address 725 E. 79TH AVENUE *ANCHORAGE, AK
79TH AVENUE *ANCHORAGE, AK
Legal description (Sub'd., Block & Lot) BELLA VISTA #1; LOT 24
Day phone 907-748-4900
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 2
APPLICATION IS FOR: APPLICATION IS AN:
(® all that apply)
TYPE OF DWELLING:
Absorption Field ❑ Initial 0
Single Family (SF) Fx]
Septic Tank(w/wo
❑ Upgrade ❑
ADU)
Holding Tank ❑ Renewal ❑
Duplex (D) ❑
Privy ❑
Multiple Dwellings ❑
(SF and/or D)
Private Well
Water Storage ❑
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.
(Signature of property owner or authorized agent)
Permit/Rush Fees: §2255 Waiver Fees:
Date of Payment: lel/IYA3 Date of Payment:
Receipt Number: 0,3_6S96- Receipt Number:
Permit No. 05102 H I( Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\FormsUient Forms\Permit Application.doc
a.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231411, Deb Wockenfuss, 12/18/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231411, Deb Wockenfuss, 12/18/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231411, Deb Wockenfuss, 12/18/23
E1
2 LOT 23
LOT 19
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℄ E. 79TH AVENUE
LOT 25B
LOT 25C
S1
2 LOT 18
LOT 20
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Lot 24
Bella Vista Subdivision No. 1
43,200 Sq. Ft. +/-
725 E. 79th Avenue
1 Story Wood Frame House
With Attached 1 Car Garage
PROFESSIONAL SEAL
Date:Frontier Surveys, LLC Project No:
650 W. 58th Ave. Suite E Anchorage, Alaska 99518
As-Built Survey of:
www.frontiersurveys.com
Frontier Surveys, LLC
I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or
under my direct supervision on
Plat:Grid:Ordered By:
907.460.1686 - info@frontiersurveys.com
This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and
conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any
inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the
existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances
should this document be used for construction or for establishing a boundary or fence line.
August 31st, 2023.
Legend:
Scale 1" = 40'
Gas Meter
Electric Meter/Outside Power
Deck
Septic
Telephone Pole
Fence
Mailbox
Overhead Utility
Lot 24, Bella Vista Subdivision No. 1
General Notes:
1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws.
2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey.
3. All measurements/setbacks are to the visual/apparent building footprint.
4. All dimensions to property lines are plus/minus 0.1ft.
Nicole Perry
23-349 09/05/2023
P-173 2231
Water Well
Tel. Pedestal
Concrete
MB
G
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[T
W Culvert
Sep 05, 2023
R
E
GISTEREDPROFESSIO N A L L A N D S URVEYORPierre M. Stragier
No. L.S. - 9812
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Legal Description: Bella Vista #1; Lot 24
Parcel ID: 013-051-36
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled *1958(?) Total depth 55 ft
Cased to 55 ft
0 Sanitary seal is functioning correctly
❑■ Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 2/14/2024
Well production at time of test **3.5 gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes X Nc
❑■ Coliform bacteria is Negative
Nitrate mg/L O Nitrate less than MRL (ND)
Arsenic ug/L O Arsenic less than MRL (ND)
Collected by GEG, LTD
Static water level at beginning of test 34 ft. Date ***8/31/23
Comments WELL DEEPENED ON 2/14/2024 "PER ALPINE DRILLING WELL LOG (ATTACHED) —WATER SAMPLES PULLED PRIOR TO WELL DEEPENING
PUBLIC SEWER
ANK DATA
operating fluid level in septic tank _
Date of purr
❑ Required
Comments:
nce completed, if AWWTS
Which system tested (date installed) "
❑ ALL standpipes present per record drawin
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade - ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
❑ Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) -
If yes, enter date -
Comments/Deficiencies:
COSA Checklist June 2022
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date
Results ❑ Pass
Fluid depth prior to test _
Water added - gal
in
New fluid depth in
EI ed time min
Final flus epth in
Absorption ra gpd
FIELD STATUS — T RECOVERY
Effective depth (per rec6ld drawings) _
Effective depth used i
Effective depth remaining - in
in
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100'
NSA
Community Sewer Manhole/Cleanout > 100'
❑Yes
if No ft
p■ Yes if No ft
Neighboring Tank > 100' Di Yes
if No ft
Private Sewer/Septic Line > 25' Q Yes if No * ft
Absorption Field on Lot > 100' ❑ Yes
if No NSA ft
Holding Tank > 100' rs� Yes if No ft
Neighboring Absorption Fields > 100'
Animal Containment > 50' Q Yes if No ft
Q Yes
if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ❑■ Yes
if No ft
Q Yes if No ft
❑ N/A — Served by Community
Well (not on lot) or Public Water PUBLIC SEWER
From Sep i ng Tank and Absorption Field(s) on Lot
to: (Please enter distances if less than required)
Building Foundations >>110'
if No ft
Surface Water > 100' ❑ Yes if No ft
Tank to Property Line > 5' E] Yes
if No
Wells on Adjacent Lots:
Field to Property Line > 10' FI Yes
if No ft
ells > 100' ❑ Yes if No ft
Water Main > 10' E] Yes
if No ft
Community Wells > Yes if No ft
Water Service Line > 10' ❑ Yes if No ft If tank or field is under driveway
F. ENGINEER'S COMMENTS
*ONLY CONSIDERED SEWER LINES EXTERIOR TO THE HOUSE.
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Garness Engineering Group, LTD. (GEG) Phone 907-337-6179
Engineer's Printed Name Jeffrey A. Garness Date
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 date/s 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 systems; therefore, GEG makes no warranty (express or implied) regarding
the future performance of the well or septic system. GEG makes no representation whether an aftemative 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.
COSA Checklist—June 2022
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Alpine Drilling & Enterprises
Well Log
Permit Number: #SW231411 Date of Issue: 12-18-23 Parcel Identification Number: 01305136000
Date Started: 2-10-24 Date Completed: 2-14-24 Is well located at approved permit location? ❑ Yes ❑ No
Legal Description: Bella Vista #1 Lot 24
Property Owner Name & Address: Brian 8 Kandy Broderick
Borehole Data: Depth (ft)
Method of Drilling x air rotary ❑ cable tool
Soil Type, Thickness & Water Strata From To
Casing type:
Existing 6 inch well and 3x3x10 Well Pit 0 52
Wall Thickness: inches
silty gravel H2O 52 55
Diameter: inches Depth: feet
Liner Type: steel
Diameter: 4 inches Depth: 55 feet
f
Casing stickup above ground: 1_5 feet
Static water level (from ground level): 34 feet
l :1 31(j�
Pumping level: 52 feet after
4 hours pumping 3_5 gpm
' 1
Recovery Rnte: 3_5 gpm
Method of Testing: pump
C yvtt='sZr `
Well Intake Opening P g TyPe:
x Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
❑ Perforations Start feet Stopped feet
Grout Type: Bentonite Volume: 4bgs
Depth: Start 10 feet Stopped 52 feet
Pump: Intake Depth feet
Pump size hp Brand Name
Well Disinfected Upon Completion? x Yes ❑ No
i
Method of Disinfection: chlorine tablets
Comments: 4 inch was installed inside existing well pit
and 6 inch casing. Grouted from 10'to 52'. Bentonite
chips to be added above 10 feet when waterline is
installed and pit is decommisioned
Well Driller: Alpine Drilling & Enterprises
�1 IPO
Box 110495
y
Anchorage AK 99511
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