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Home My WebLink AboutHARNESS LT 3Harness Lot 3 #016-112-45 Z�1"Ztll71�, `17 t.C. STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING, LAND & WATER War".rTtt'lf '1Drilfinylczmi'Pufill, serNL,: WATER WELL LOG Drilling Started: _9__/-2L/2014Completed: -9-/2014 City/Borough: Subdivision: BLOCK LOT Property Owner Name & Address: Clayton Parrins ite:11530 Reader Rd nchorage Harness 3 Meridian Township Range Section '/4 Of '/4 Of --'/4 Of '/4 BOREHOLE DATA(from top Of casing)Depth Drilling method: (X) Air rotary, ( ) Cable tool, Other Material: Type, Color & wetness I From 1 Tu Well use: ( ) Public supply, (X) Domestic, Other stickup 0 2 Depth of hole: 95 ft, Casing stickup: 2 fr Casing Type: steel Thickness: .250 inches Casing diameter: 6 inches Casing depth: 95 ft clay 2 8 Liner type: Diameter: _inches Depth: ft Static water (from top of casing): 27 ft on 09 / 28 2014 clay w/ gravel 8 15 pumping level & yield: _ feet after __ hours at gpm Recovery rate: 35 gpm, Method of testing: airlift clay 15 40 Development method: airlift Duration: 1 hour Well intake opening type: (x ) Open end.. ( ) Open hole, Other_ sand w/ little H2O 40 45 Screened: Start: ft, Stopped fr Screen type: Slotimcsh size. moist clay 45 60 Perforated; Start: ft, Stopped: ft Start: ft, Stopped: ft clay w/ gravel 60 67 Note: ............................... ....................................................... ........ Grout type: bentonite Volume - sand w/ gravel &H2O 67 90 Depth; from around surface , to 20 ft Pump intake depth: 70 ft coarse gravel w/ H2O 90 95 Pump size: 3/4 hp, Brand name: Grundfos SClE Was well disinfected upon completion? (X) Yes, ( ) No Method of disinfection: .CialCiUfo. Hyp-orblorite..(Cblorine)... Driller comments/ disclaimers: ............... ............................... : ............ coliformCot 100ML ............................................................................................................. ............................................................................................................. Nitrates_ m ...............................................................................................I............. Arsenic ug/ o nny ay Well driller name:.. ............ . ....................... ................................ ....... Company name:... Hgfty Drlllingf..InC........................................... Mailing address:...3540 Akula D .. ... .............................. a ffi�m , y s city: Anchorage State: AK zip 99516 Phone number : ( 907 ) 45 - 0593 fax:345-4700 Drillers signature: Alaska state law requires that a copy of this well log be sent to the Department of Natural Resources within 45 days: faxes arc acceptable. (AK statutes 38.05.020, 33.05.035, 41.08.020, 46.15.020 and AK regulations I I AAC 93.140). DNR/ Division of Mining, Land and Water, 550 W 7th Avenue, Suite 1020 Anchorage, AK 99501- 3562 Phone(907)269-8639 and fax(907)269-8947 Within the City of Ancbor ge, it is required that a copy of the well log be sent to the appropriate city office within 60 days and that another copy of the well log be sent to the well/property owner within 30 days. Permit Number: OSP141395 Date of issue: Sep / 25 2014 Parcel Identification Number: - Is well located at approved permit location')( X) Yes or ( ) No Development Services Department Building Safety Division ;A� On-Site Water & Wastewater Program 4700 Elmore RoadP.O. Box 196650 Mark Begich Anchorage, AK 99507 Mayor www.muni.org/orgite (907)343-7904 Pump Installation Log C Well Drilling Permit Number:+S __os P lqi 395 Date of Issue: �'11J �5 2 a Parcel Identification Numbers - Legal Description Property Owner Name & �Addre s: �e/'r�%I s W .2010 15n'010- Pump 5r;0k Pump Installation Date: la/1 11q Pump Intake Depth Below Top of Well Casing: 7p feet Pump Manufacturer's Name: G rwwr .�e Pump Model: /0 �j,e a? b-2IXo /y Pump Size " hp / Pitless Adapter Burial Depth: /O feet Pitless Adapter Manufacturer's Name: s- / V Pitless Adapter Installer: C %5 T " . Well Disinfected Upon Completion? (YI Yes n No Method of Disinfection: I Comments: Pump Installer Name: 5671 y V CI -t Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. SGS ReLM 1150799001 Client Name Residential Testing -Cash Account Project Name/# Well Water Can Kit Client Sample ID Well water Matrix Drinking Water Printed Date/Time 03/11/2015 15:32 Collected Date/Time 03/06/2015 15:00 Received Datefrime 03/06/2015 17:10 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 Waters Department Total Nitrate/Nitrite-N Microbiology Laboratory E. Coli Total Coliform 5.98 5.00 ND 0.100 Negative 1 Negative 1 ug/L EP200.8 C (40) 03/09/15 03/09/15 EAB mg/L SM214500NO3-F B (<10) 100mL SM219223B A 100mL SM219223B A 03/10/15 RTS 03/06/15 MEV 03/06/15 MEV Permit Number: Tax Code Number: On -Site Water System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 OSP141395 01611245000 Work Type: Well Initial Permit Effective Dates: September 25, 2014 to September 25, 2015 Design Engineer: Subdivision: HARNESS Site Legal Address: HARNESS LT 3 G:2633 Owner/Address: FRAME APRIL B & PERRINS CLAYTON W 3060 BRIDLE LANE ANCHORAGE AK 995171470 Site Mailing Address: 11530 Reader RD, Anchorage This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 54475 Total Bedrooms: 4 Y Private Well N Water Storage All construction must 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 must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: By: Date: I AL511 Date:*5- MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 0161/2=q5 - Property owner(s) 161%2=q5-Propertyowner(s) &- I /nAtAy,^ Veyvi'65 Day phone Mailing address _ Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Lot Size 5Lj?�-f5 Sq. Ft. APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Q Water Storage ❑ APPLICATION IS AN: Initial Upgrade ❑ Renewal ❑ TYPE OF DWELLING: Single Family (SF) [�( (w/wo ADU) Duplex (D)_ ❑ Multiple Dwellings ❑ (SF Sti TTA SEP 152014 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Bob Marker Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Permit/Rush Fees: 1-7 j/S. Date of Payment: `l'/<-' /N Receipt Number. 0/5'i9io Permit No. 05PI'413as Permit App_9-1-12.doc Waiver Fees: Date of Payment: Receipt Number: Waiver No. DATUM NOTE THE DATUM OFIS SURVEY IS ASSUMED. THE LEVATION OF THE 5/8" REBAR, CE 1/16 CORNER, WAS ASSIGNED AN ARBITARY ELEVATION OF 200.00 FEET. l 1 "I�., COW LEGEND FOUND 2 1/2" ALUM. ® PUBLIC SIGN CAP MONUMENT FOUND 5/8" REBAR XX XX XX MEASURED DATA UTILITY POLE (XX XX XX) RECORD DATA P92-70 UTILITY POLE WITH LIGHT GUY ANCHOR DRAIN INLET SEWER MANHOLE r 1rr1 An Al ^I ren/I //^//lA/ L_L/V l / l/ / /lT L -L/ v (569°52'32"9 216.20 -Sd9'051'13"E'-215.98' _ 10' AUX. 'rL0T 3 75\t I PROPOS! WELL PROP059D 2-57ORY MHE \ HOU59 °WER CONN. --Ti f.[ ^nlI/l/1/ T )n/%T n .r7vvL /RAS I n n--, ?0r./. R N I PROPOSED / 570R.1cE 1 /r SFICD 1 I J 119.4' C I� 30.D' I —I — PROP05EO t+84WL DRMWAY_ 0 � r U NC 102.0' J (589 "5T00"9 21 t N89°57'00"W 216.09' SEWER LPIE X 201.1' SPOT ELEVATION —DE— OVERHEAD ELECT. DRAINAGE FLOW / L_L/ —' II 8 E i MONA AVE. - 5 Fl 12, CW C15- � I 0QI //lT e) LIJ Yp L. L/ l I E N 7/ I/A/ 33RLI" y .:, 2 �C,T AnnA/ / .J / /TUU/ v p Wco L ►W N CY � M y 0 °o tyLNn N is 1 M 10' AUX. 'rL0T 3 75\t I PROPOS! WELL PROP059D 2-57ORY MHE \ HOU59 °WER CONN. --Ti f.[ ^nlI/l/1/ T )n/%T n .r7vvL /RAS I n n--, ?0r./. R N I PROPOSED / 570R.1cE 1 /r SFICD 1 I J 119.4' C I� 30.D' I —I — PROP05EO t+84WL DRMWAY_ 0 � r U NC 102.0' J (589 "5T00"9 21 t N89°57'00"W 216.09' SEWER LPIE X 201.1' SPOT ELEVATION —DE— OVERHEAD ELECT. DRAINAGE FLOW / L_L/ —' II 8 E i MONA AVE. - 5 Fl 12, CW C15- � I 0QI KLATT ROAD C9 1/16 N89" 57'00"W BASIS OF BEARING //'% I II I 30.00' * :49�i� ••� .1 •.........e— MICHEAL P. FRAME �� • LS 6093 �•� : t� 14.14• •..`�� • 25 50 75 100 SCALE Mich"I A Frame, PLS P.O. Box 770417 EAGLE RIVER, ALASKA 99577 (907) 444-6077 FIELD WORK DATE: XXX)XXXXX PARTY CHIEF: MPF DRAWN DATE: MAY 20, 2013 DRAWN BY: SKS PLOT PLAN SURVEY I hereby certify that I have, or someone under my supervision has, surveyed the property described as: LOT 3 OF LOTS 1,2 & 3, HARNESS SUBDIVISION LOCATED WITHIN NE 1/4 SEC. 20, T12N, R3W SEWARD MERIDIAN, ALASKA ANCHORAGE RECORDING DISTRICT Monuments have been found and/or set as indicated. The improvements situated thereon are within the property lines and do not encroach or overlap onto adjacent properties, nor do any improvements from adjacent properties encroach or overlap onto this property, except as indicated hereon. The property dimensions shown in parenthesis are from the record plat and are not necessarily as we may have measured. Additional data shown hereon should not be construed to "replat" or "resubdivide" any property and is shown for information only. Drafting and reproduction may produce graphic Inconsistencies; therefore scaling should not be attempted to determine unshown dimensions. Only easements from the recorded subdivision plat noted above are shown hereon and it Is the responsibility of the owner to determine if any other easements, covenants, or restrictions exist. This document is authorized to be used for one real property transaction or project only. Any copy is to be considered unauthorized unless it bears an original surveyors signature (usually In blue Ink) or a stamp showing recorder's office data. Lending Institutions may make additional copies for their own records. Liability to Micheal P. Frame, PLS Is limited to fees received for this project. FIELD BOOK: XXX PLOT SCALE: 1"=50' GRID: XXXX DWG NAME XXXX JOB NO: 13—XXXX L.Vr LIJ I Q I 7/ I/A/ 33RLI" y .:, 2 �C,T AnnA/ / .J / /TUU/ v L KLATT ROAD C9 1/16 N89" 57'00"W BASIS OF BEARING //'% I II I 30.00' * :49�i� ••� .1 •.........e— MICHEAL P. FRAME �� • LS 6093 �•� : t� 14.14• •..`�� • 25 50 75 100 SCALE Mich"I A Frame, PLS P.O. Box 770417 EAGLE RIVER, ALASKA 99577 (907) 444-6077 FIELD WORK DATE: XXX)XXXXX PARTY CHIEF: MPF DRAWN DATE: MAY 20, 2013 DRAWN BY: SKS PLOT PLAN SURVEY I hereby certify that I have, or someone under my supervision has, surveyed the property described as: LOT 3 OF LOTS 1,2 & 3, HARNESS SUBDIVISION LOCATED WITHIN NE 1/4 SEC. 20, T12N, R3W SEWARD MERIDIAN, ALASKA ANCHORAGE RECORDING DISTRICT Monuments have been found and/or set as indicated. The improvements situated thereon are within the property lines and do not encroach or overlap onto adjacent properties, nor do any improvements from adjacent properties encroach or overlap onto this property, except as indicated hereon. The property dimensions shown in parenthesis are from the record plat and are not necessarily as we may have measured. Additional data shown hereon should not be construed to "replat" or "resubdivide" any property and is shown for information only. Drafting and reproduction may produce graphic Inconsistencies; therefore scaling should not be attempted to determine unshown dimensions. Only easements from the recorded subdivision plat noted above are shown hereon and it Is the responsibility of the owner to determine if any other easements, covenants, or restrictions exist. This document is authorized to be used for one real property transaction or project only. Any copy is to be considered unauthorized unless it bears an original surveyors signature (usually In blue Ink) or a stamp showing recorder's office data. Lending Institutions may make additional copies for their own records. Liability to Micheal P. Frame, PLS Is limited to fees received for this project. FIELD BOOK: XXX PLOT SCALE: 1"=50' GRID: XXXX DWG NAME XXXX JOB NO: 13—XXXX 1 8 9 10 MUNICIPALITY OF AN -,? ' t Development Services Department P re: 907-343-7904 On-Site Water & Wastewater Section x: 907-343-7997 c> Certificate of On-Site Systems Approval '- >v 9 Parcel I.D. 016-112-45 Expiration Date: H LI - 15 1. GENERAL INFORMATION Complete legal description Harness L3 Location (site address) 11520 Reader Rd Current property owner(s) April B. Frame & Clayton W. Perrins Day phone (907) 854-9360 Mailing address 22630 Reader Road Anchorage AK 99516 Real estate agent Day phone 2. TYPE OF DWELLING: I Single Family (w/wo ADU) E Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic n Water Storage ❑ Holding Tank Community Well ❑ Community n Public Water System (J Public Sewer n Waiver request for:• Distance: Received by: Date: COSA to be released to the engineer.unless otherwise requested by the engineer. COSA Fee $ 55O Waiver Fee $ Date of Payment a Jia/i9 Date of Payment Receipt Number 64,4 ?.n Receipt Number COSA# Qoe /c3 033 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 2/11/19 oF•••��rrrr�,+ • ,i / 49th �% 6. DSD SIGNATURE •• System #1 Approved for +•��, 3 bedrooms • ,� MICHAEL E. ANDERSON System #2 Approved for bedrooms ++*jf, No. CE-4381�, � Y pp +��pF.. 2/1in9V••, e • Disapproved +h+�;;;; ;:�•• Conditional approval for bedrooms, with the following stipulations: ON- WATER ITE WASTAND �, wass•-WATER`' s. SERVIC By: Original Certificate Date: a,— J Li-1(i 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 COSA Checklist Legal Description: Harness L3 Parcel ID: 016-112-45 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) Well production at time of test 6.2 gpm Date drilled 9/28/14 Water storage tank volume gallons Total depth 95 ft Well disinfected for coliform test? ❑ Yes 1E No Cased to 95 ft 1=1Coliform bacteria is Ne tive • Sanitary seal is functioning correctly Nitrate mg/L [('itrate less than MRL (ND) •Wires are properly protected Arsenic ug/L [Arsenic less than MRL (ND) Casing height (above ground) 24 in. Collected by Forge Engineering Date of flow test for COSA 2108"9 Date of Sample 2105/19 Static water level at beginning of test 31 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) years ❑ Required maintenance completed Tank type/material Age of lift station years Measured operating fluid level in septic tank Lift station material ❑ Standpipes/foundation cleanout per record drawing Comments: AWWU Sewer Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) Adequacy test date ❑ALL standpipes present per record drawing Results ❑Pass For bedrooms Total measured depth from grade ft (max) Fluid depth prior to test in Measured depth to pipe invert from grade ft(min) Water added gal ❑ N/A—pressurized field New depth in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective II] Code-requiredsoil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies:AWWU Sewer COSA Checklist yellow sheet 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' Community Sewer Manhole/Cleanout> 100' ❑ NSA Yes if No ft ❑✓ Yes if No ft Neighboring Tank> 100' ❑✓ Yes if No ft Private Sewer/Septic Line>25' ❑✓ Yes if No ft Absorption Field on Lot> 100' ❑Yes if No NSA ft Holding Tank > 100' ❑Yes if No NSA ft Neighboring Absorption Fields> 100' Animal Containment> 50' 0 Yes if No ft O Yes if No ft Manure/Animal Excreta Storage> 100' Community Sewer Main> 75' 0 Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' ❑Yes if No NSA ft Surface Water> 100' ❑Yes if No NSA ft Property Line> 5' El Yes if No NSA ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No NSA ft Private Wells> 100' ❑ Yes if No NSA ft Water Main > 10' El Yes if No NSA ft Community Wells>200' El Yes if No NSA ft Water Service Line> 10' ❑Yes if No NSA 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' IDYes if No N/A ft If absorption field is under driveway comment below Property Line > 10' [' Yes if No NSA ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No NSA ft Private Wells> 100' 0 Yes if No NSA ft Water Service Line> 10' ❑ Yes if No NSA ft Community Wells>200' ❑Yes if No N/'A ft Surface Water> 100' ❑ Yes if No NSA ft F. ENGINEER'S COMMENTS 40 nF G. ENGINEER'S CERTIFICATION ``PSPq.. �.0 I certify that I have determined through field inspections and review s �- 1,,._ �'o- VA of Municipal records that the above systems are in conformance with �, 't;- 49th \ .* .0 MOA COSA guidelines in effect on this date. ;, g ---- ,.,,,,-- .,;� MICHAEL E. ANDERSON p oLo im 4r 1/ •.0�'f,•'-. N o. CE-4381 .. ,.''i .46 -1/45) I. ,: 2/11/19 .----C`C��i COSA Checklist yellow sheet ♦v.,p CO.�*••+•......-*'"-- *, IP