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HomeMy WebLinkAboutGIRDWOOD ORIGINAL TOWNSITE BLK 3 LT 27 US SURVEY 1177 SUPPLEMENTGirdwood Original Townsite Block 3 Lot 27 #075-153-15 Certified Drilling Log ..P BILL 8 COLE OC CO dbe t► IILLIIIAV WATER WELLS 688-2759 'P.O. Box 670269, Chugiak, AK 99567 OWNER OF LAND: HEATHER ELDRED ADDRESS: 20211 MCKINLEY VIEW AVE. LEGAL DESCRIPTION GIRDWOOD ORIG. TOWNSITE B3 L2 DATE: 5-28-15 PERMIT NUMBER: 151106 DATE OF ISSUE: 5-13-15 TAX IDENTIFICATION NUMBER 07515315000 Is well located at approved permit location: MYes LINO Method of Drilling: ®air rotary ❑cable tool Depth of Well: 64' Casing Type: Steel Diameter: 6 Liner type Wall thickness inches, depth .250 inches 64 feet Static Water Level: 3 feet Recovery Rate 60 ® gpm ❑ gph Method of Testing Air Well Intake Opening Type: /a open end ❑open hole feet Stopped feet Stopped ri Screened n Perforations Grout Type: Start Start Bentonite Volume: 50 Ibs Depth: from 2 feet, to42 feet Well Disinfected Upon Completion: Myes [ no Method of Disinfection: Chlorine 50 PPM Comments: Bore Hole Data Depth From To 0 2 2 4 4 31 31 52 52 64 Casing Stickup Overburden Clay Silt with some Gravel Gravel and Silt (Water Silty) Sand and 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. j ULLIIIAN cWATER WELLS P.O. Box 670269, Chugiak AK 99567 688-2759 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP1S1106 Date of Issue 5-13-15 Parcel Identification Number: 07515315000 Legal Description Girdwood Original Townsite Block 3 Lot 2 7 Property Owner Name & Address Heather Eldred 20211 McKinley View Ave Chugiak, AK 99567 Pump Installation Date: 9-26-15 Pump Intake Depth Below Top of Well Casing: 46 feet Pump manufacturer's Name: Goulds Pump Model: 10HS05412CL Pump Size: 1/2 hp Pitless Adapter Burial Depth: 6 feet Pitless Adapter Installer: Unknown Disinfected Upon Completion? // yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson B1OX Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 41 1 L 13315 91915 viTt ALS 3106 I$ 5661 trout um .0S -1101 3105 3114081d 9 NYId 133815 NNW 2-V3 011 '8 6-09 011 000M0?IO 010 NOIS30 113135 8 sr 53403106 %X00-0215-r6h6 t %X00-oat-t5t5. 0•M'0'M'MY A111LLA 2131VM31SYM 9 2131YM 30'010HONY 30V2I0HOHV 3O ALERMICH Ulf( IMILTISMOO 1065 . 00,0.110061..01.1 %90 IML / 31Y1SF10000 VOLVO 7124.610A IYLLVO TIOLLBM. 080010 Na1J0W1000 s. 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EASEMENT M O0. w 0 M 560'45'42"W 120.36' (M) 560.49'10"W 120.32' (c) COLD AVENUE 0 30' 0 w J .1 0 o M CC w N SCALE: 1"=20' OWNER: HEATHER ELDRED CHECKED; KRH N 0 co N W H 0 j D 2 0 ¢ z 0 d 00. 0 d 0 FOUND 5/8" REBAR : 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 Permit Number: OSP151106 Tax Code Number: 07515315000 Work Type: Well Initial Permit Effective Dates: May 13, 2015 Design Engineer: Subdivision: GIRDWOOD ORIGINAL TOWNSITE to May 12, 2016 Site Legal Address. GIRDWOOD ORIGINAL TOWNSITE BLK 3 LT 27 US SURVEY 1177 SUPPLEMENT G:5112 Owner/Address: ELDRED HEATHER M 20211 MCKINLEY VIEW AVE CHUGIAK AK 995675811 Site Mailing Address: 213 MAIN ST, Girdwood Lot Size in Sq Ft: 10800 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank N Privy 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. Special Provisions: Opperational approval of the well is contingent on submittal of the following items. 1.Well Log 2.Well Pump Installation Log 3.Water quality test results for Coliform Bacteria, Arsenic and Nitrate. Received By: Issued By: Date: Date: MUNICIPALITY OF ANCHORAGE Community Development Department i/l Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program w� ON-SITE SEWER/WELL PERMIT APPLICATION SUBMITTAL MAY 0 a 2015 Parcel I.D. 075 153 15 000 1 3 Property owner(s) Heather M Eldred Day phone 907-632-5272 Mailing address 20211 McKinley View Ave. Chugiak, AK 99567 Site address Lot 27, Block 3 Girdwood Original Townsite, (corner of Gold and Main) Girdwood, AK 99587 Gretchen Stuller Legal description (Sub'd., Block & Lot) Girdwood Original Townsite, Block 3, Lot 27 US SURVEY 1177 SUPPLEMENT Legal description (Township, Range & Section) Lot Size 10,800 Sq. Ft. Number of Bedrooms Will be 3 APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage APPLICATION IS AN: Initial Upgrade Renewal TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) Multiple Dwellings (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: x❑ I certify that the above information is correct. I further certify that this is in accordance with applicable Mynicipal Codes. s. y ` l (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: 15 Receipt Number: 5512 Permit No. 1 1151110(0 Permit App__- Waiver Fees: Date of Payment: Receipt Number: Waiver No. Drawing. L.\JOBS\35150030 GIRDWOOD L2723\ACAD-DES GN\SITE PLAN \SITEPLANG-WOODL2783.DWG - Layout. 01 User. FPAULSON May 04, 2015 - 7,48am Xrefs. 85X14P-PLAT BORDER_BERS.DWG - Images. NIVW 213M3S 0118f1d z x 0 m 3f1N3AV 0100 CEA SUB STATION ALLEY O CFA EASEMENT • LOT 27 BLOCK 3 • PM 8185 PM 8286 PROPOSED WELL LOT 19 — \, LOT 20 T T LOT 12 I LOT 11 PUBLIC SEWER MAIN rerun POWERPOLE • POST o CAN Q POWER UTILITY EXTSTING GROUND ELEVATION TYPICAL o FOUND 5/8" REBAR m TELEPHONE JUNCTION BOX ® WOOD DECK ax: --1 GRAVEL DRNEWAY Win PROPOSED ELEVATION TYPICAL --o— CHAINLINK FENCE e PROPOSED WELL NOTES, 1. THE FIELD SURVEY WAS PERFORMED BY BRISTOL ENVIROMENTAL REMEDATION SERVICES LLC. FROM NOVEMBER 21, 2014 TO APRIL 2015. 2. ELEVATIONS ARE BASED ON THE M.O.A. VERTICAL DATUM 1972 NGS ADJUSTMENT, FROM M.O.A. BENCH MARK R 72 ELEVATION 24.171. SEE M.O.A. BENCH NETWORK BOOK, DESCRIPTION PAGE NO. GD -14. LOT 13 O DATE OF SURVEY: BEGIN 11/21/2014 END 3/27/2015 SURVEYOR: Bristol II ENVIRONMENTAL R EMEONl10N SERVICES, LLC 111 W. 18TH AVENUE, THIRD FLOOR ANCHORAGE, AK. 99501 Site Plan LOT 27 BLOCK 3 OF SUPPLEMENTAL PLAT U.S. SURVEY NO. 1177, ALASKA DRAWN BY: FP DATE: 5/3/2015 SCALE: 1"=30' CHECKED: KRH PROJ. NO. 35150030 OWNER: HEATHER ELDRED MUNICIPALITY OF ANCHORAGE Q � 4 Development Services Department -343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 075-153-15 Certificate of On -Site Systems Approval Expiration Date: 10-2Z" 202 0 1. GENERAL INFORMATION Complete legal description GIRDWOOD ORIG. TOWNSITE 63, L27 US SURVEY 1177 SUPPLEMENT Location (site address) 213 MAIN STREET, GIRDWOOD, AK 99587 Current property owner(s) HEATHER ELDRED Mailing address Real estate agent Day phone 20211 MCKINLEY VIEW AVENUE, CHUGIAK, AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �Vl a 1 d Waiver Fee $ 011 Date of Payment 7 7/2,ozL) Date of Payment Receipt Number 607013 Receipt Number COSA # 0 512- 9 D 1308' 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 7/3/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to +�d, these various and dynamic characteristics and are outside the control of the evaluator of the . i `�,i well and septic system. Therefore, any estimate of how long a system will function satisfactory /,�g�Q; • • • !f9 �� for current or future occupants or guarantee that no unseen encroachments, deficiencies orJJ discrepancies exist can be given by First Water Consulting & NES *' Tli , , , , ,•;* 6. DSD SIGNATURE • :• Curtis Huffman j System #1 Approved for 3 bedroomsF��, CE 128991 . �,���� 20- System #2 Approved for bedrooms l�k�- OPROFEs �o p���� Y P 11 p Disapproved Conditional approval for bedrooms, with the following st� ns: � O�F�����r�r�(i WATER AND W%'_ o WAST'!V;'ATER 0 r,eGr ARA � � -P�QCTI�7�rvr—,� T JiJ �o A'r SERv\G����`, By: �^'� `� Original Certificate Date: 7-2— ZP2-02-6 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 lili r. ;+. •y Legal Description: GIRDWOOD ORIG. TOWNSITE B3 L27 US SURVEY 1177 SUP. Parcel ID: 075-153-15 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 5/28/2015 Total depth 64 ft Cased to 64 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 48+ in. Date of flow test for COSA 6/25/2020 Static water level at beginning of test 3 ft. Well production at time of test 4+ gpm Comments B. TANK DATA - NA Age of tank(s) _ years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA - NA 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, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Com ments/Deficiencies: Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 0.387 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) rkrs Collected by Date of Sample 6/28/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date Results ❑ 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 FWcs 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' Building F-oundations > 10' ® Yes Community Sewer Manhole/Cleanout > 100' ft Surface Water > 100' ® Yes, --'if No ft ❑ Yes if No NA 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 NA ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ft ® Yes if No ft if iso ft If absorption field is under driveway comment below Property Line > 10' Z-'�esr if No ft Wells on Adjacent Lots Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft Frim Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building F-oundations > 10' ® Yes if No ft Surface Water > 100' ® Yes, --'if No ft � ` t Property Line > 5' �.` ® Yes if No ft Wells on Adjacent Lots:f Absorption Field > 5' Yes if No ft Private Wells > 100:--'-- ® Yes if No ft Water Main > 10' ® YYes cif No ft Community- ells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No� t If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distancesces i�hann required) Building Foundation > 10' ® Yes if iso ft If absorption field is under driveway comment below Property Line > 10' Z-'�esr if No ft Wells on Adjacent Lots _ Water Main > 10" ®Yes if No ft Private Wells > 100' Yes if No ft Water Serve -'nee >' 10' ® Yes if No _ ft Community Wells > 200' ®Yes No Surf c� e Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l 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. . 0 .. ... ....•.. • Curtis Huffman CE 128991 .•�`�,�' �� ��lF�•• 7(3/20;0•'F��.� �k�F�pROFESS00 -Ift--