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HomeMy WebLinkAboutUS SURVEY 3042 LT 1BU55 #3042 Lot i El #075-132-81 (Formerly Ll 560') • :"tion COP MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW970083 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:KESLER MICHAEL K OWNER ADDRESS:P.O. BOX 188 GIRDWOOD, ALASKA 99587 PARCEL ID:07513208 LEGAL DESCRIPTION: US SURVEY 3042 LT 1 S60' LOT SIZE: 19800 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 5/05/97 EXPIRATION DATE: 5/05/98 LD -1S Asa -$V gA \tom - ass +uI (fie w Lar -r.0 — 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: 297747z:19' 722-'6-e DATE: 5.4-4� DATE: — 77 to co co 01 rn rn 0 rn rn G, 0 A d 0 U) \ 0 2 0 m 0 - 1 ON .k3A Jns :NOLLdI 3$34 1V331 't / FC « 177 / /CI O / /� ®� ~ oz « z ,cko 7 LAArritti Page: 1 Document Name: ENTERPRISE SERVER PARCEL: 075-132-81-000-00 CARD: 01 OF 01 RESIDENTIAL SINGLE FAMILY STATUS: RENUMBERED TO/FROM: 075-132-08-000-00 KESLER MICHAEL K & EKER ERIN A PO BOX 188 GIRDWOOD AK 99587 0188 SITE US SURVEY 3042 LT 1B LOT SIZE: 12,363 ZONE : R11 TAX DIST: 004 GRID . NOTES : REF 075-132-08 ---DATE CHANGED --- OWNER : 09/23/97 ADDRESS: 09/23/97 HRA # : 000000 FINAL VALUE 1997: FINAL VALUE 1998: FINAL VALUE 1999: EXEMPT VALUE 1999: STATE EXEMPT 1999: FINAL VALUE 1999: 0 41,700 41,700 0 ASSESSMENT HISTORY --BUILDING- --- 0 135,700 135,200 0 ----DEED CHANGED --- BOOK : 3124 PAGE: DATE : 09/17/97 PLAT : 970072 TOTAL --- 0 177,400 --EXEMPTION 176,900 TYPE -- 0 0 176,900 -COMM COUNC Date: 4/9/99 Time: 07:33:43 AM Well Owner M -W DRILLING, Inc. P.O. Box 110378 • 10330 Old Seward Highway (907) 349.8535 ANCHORAGE, ALASKA 99511 DRILLING LOG MICHAEL KESLER Location (address of: Township, Range, LOT1 S60', US SURVEY 3042 h1_i_91 WAS \s -'i5S Ss1 Use of We1DOMESTIC Section, if known; or distance main roars GTRf)W!1(1f\ ALA RICA Size of casing 6o Depth of Hole 80 feet Cased to 80.14 feet Static water level 59 ft. (OM). (below) land surface. Finish of well (check one) open end ( X ); Screen ( ); Perforated ( ). Describe screen or perforation N/A Well pumping test at 7 5 gallons peixtbtt (minute) for 1 hours with 100% ft. of drawdown from static level.' lr ' AS BUILT NOTES:1) WELL DRY GROUTED WITH -"'c ,2 SACKS OF BENTONITE GRANULES. Date of completion 30 MAY 1997 I-;, ,-a WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness R TO f nSTNC STInir UP 2 15 32 TO TO TO 60 ' TO 75 TO 80 TO TO TO TO TO TO TO TO TO 15 32 60 75 GRAVEL: BROWN, SILTY GRAVEL: GRAY, SILTY GRAVEL: SILTY, CLAYEY, DAMP WATER 'GRAVEL: SANDY, DIRTY WATER GRAVEL: SANDY.~CIE AN R l• N95e6 0 of P1, �o oots taut r� i NJ�9 ‘'w tor is Cee,C o 1,1-‘oteto e:m- 1—CUSTOMER sio oo2Wm C C . 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N o 00 ar`^ • 'C� 44�Ye<or (q�G `��o CRFFk FS/C1 11711/1/) tiwY "�r�� r 0 / / • t0 CO • • PTGt 80 Municipality of Anchorage ° •� - On-Site Water and Wastewater Program i3O I i (907) 343-7904 SAFETY Certificate of On-Site Systems Approval Parcel I.D. 075-132-81 Expiration Date: / '7o Y-C 1. GENERAL INFORMATION Complete legal description US Survey 3042 Lot 1 B Location (site address) 118 Monarch Mine Rd. Current Property owner(s) Stephen T. Evans Day phone 351 -9208 Mailing address PO Box 631 Girdwood AK 99587 Real Estate Agent Day phone 2. TYPE OF DWELLING: E 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 CI Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer LI WaiverNariance request for: Distance: Received by: Wit64U44)-Y1 VI`J Date: I4Si17 • COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 1 . 100 Waiver Fee $ Date of Payment 12.)5 /11 Date of Payment Receipt Number 031 3� Receipt Number COSA# 0 S C 111 5 51- 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 Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave. Suite 203 Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller Date 11/26/17 �A*'•49111 .7 6. DSD SIGNATURE ' — .* 41 System #1 Approved for 3 bedrooms ••• �� r . Beni in Schiller : A' System #2 Approved for bedrooms fT#014-94,,,....11:)(4 -V,, �z 92 .•%;; i Disapproved #01'..9- !1aw ("1.•:,.;,::-.1- Disapproved PRo;;ss;o*P Conditional approval for bedrooms, with the following stipulations: � •rtt kF i,„,,c.( . �Q � 4 o' J' ON-SITE .7-5 AND m' ° WASTEWATER c 4 PROGRAM �__ D ,off �"'F SERA ... By: '`d R n Trn 2ckhu;rql Original Certificate Date: 1,2/0 5/2 0 1 7 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 blue sheet S ., c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: US Survey 3042 Lot 1B Parcel ID: 075-132-81 A. WELL DATA Y Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Date completed 5/30/97 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y 80.14 Casin hei ht above round in. Total depth 80 ft. Cased to ft. 9 g ( g ) 30 FROM WELL LOG AT INSPECTION Date of test 5/30/97 11/13/17 Static water level 59 60 ft. ft. 7.6 m. Well production 25 g.p.m . WATER SAMPLE RESULTS: ND Coliform colonies/100 mL Nitrate 0.382 mg/L Arsenic N Dug/L Date of sample: 11/13/17 collected by: Forge Eng. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Public Sewer Date installed Tank size gal. Number of Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) Depression over tank (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 ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >_ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots >100 Absorption field on lot N/A On adjacent lots >100' Public sewer main '75' Public sewer manhole/cleanout >100' Sewer/septic service line '25' Holding tank >75' Animal containment areas '50' Manure/animal excrete storage areas >1001 SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and Aik) review of Municipal records that the above systems are in �Q'•' '•�1.:7 f- conformance with MOA COSA guidelines in effect on this date. 0*:•49 mi '.*�,I Engineer's Printed Name Benjamin Schiller 1 •• ••...... .. ..... Date 11/26/17 l� �•,• Eenja Schiller � C 1292 • COSA brown sheet_10-10-12.doc LOT 1 - to \ \ �y 6 51 L 0 T 1A o w0 EXISTINGj p BUILDING 6 -?D.' .-*-- ti i0• T 763 .7 s. cv 1\ rye. o ��f,Qv ,5 Z 3 rye. ¢ f4ec \ \ h. 32 was fM •-.__,. fNI • O 7 3 \ -7 h X74- �'0 Ai LOT 1B ^ -7 Iv OngRC•, o2 �v 104 \ J ,o \ M/Ne '63 tfcf �pF.7s, Asf4,fT R �" q••°pp 40 / . ,4qp " 90� ,. 5x`(/).• 49TH* "•77 'OA \ e, D I • • d Mork E. Davis ~(' �v 0, LS-7338 •' +pO 444 ra ' 00,f5, , ro4essionol\,= �Dovoo .. LOT 72 • LEGEND: SET FND 5/8'R8 w/CAP® 5/8' R8 0 oRocaco ev. ERIN EKER SCOTT _ X1.25' AL.MIkt. (bUC1UMENT 4 "1�___.,� AS— BUILT OF: LEGAL DESCRIPi10TJ: 70- ,..,.�, "HUB k TACK 0 .t►�rtK►�KM Cw�'►I KriK -..:7_,.L37.11_1:7„_17.:::..--7 `.� k.r.r s.l itiit- f.r.l.e be be a `ENCS- —x.— x SURVEY GERIIFICATION: IANTECH hos conducted o physical survey of this VERHANG- <<sr �a — .�,._�. �.��. LOT 18 s property as shown on this as+nq and lnol the improvements siluolcd thereon ,roOO DECKS- v-_-_-=_7--,4 )FIS-PLANNERS-ENGINEERS ore ■.tnin the property Ines and no encroochments evil other (hon noted CONCRETE- r. • vel S Li . S. SU R '/E Y 30 42 ExCLUSION NOTE: It is the owners' responst,ilty to determine the existence ASPHALT- I I 562-5291 (14x)561-6626 of any easements. covenonts, or restrictions which do not oppeor on the CRAVEI- I recorded subdivision plot. NOTE: Under no circumstances should any data SEPTIC STANDPIPES-Q "" ~. " -. 04.0:1 II. ms•a hereon be used for construction or for cstablishin r ert lines. SEPT. 15. 1997 I DMD 5012 I KEN 391/1 property y -WATER KILL- Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING ,t� COSA# U t - s�- Parcel I.D. 025 —/3e2- g/ 1. GENERAL INFORMATION w Expiration Date: / / ` / 0 — 0 9 Complete legal description USS 3042 LOT 1 B Location (site address) 118 MONARCH MINE ROAD "GIRDWOOD, AK Current Property owner(s) ERIN EKER Day phone 230-7266 Mailing address 118 MONARCH MINE ROAD "CIRDWOOD, AK Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank ❑ Community On-site ❑ Public Sewer • The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs urSon request to homeowners. Certificates of On -Site Systeme Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ►� Approved for 3 bedrooms. Disapproved. Conditional approval for Date Oh •••'* Gar ess. CE -7// 3 .•'.�cEO� 8Ii{�' Eo°o V Pro lessiofO C 1((111 u u rr rr : o • ON-SITE:: WATER AND WASTEWATER : bedrooms, with the Mowing stipulations. PROGRAM•• �G•' •,o. 2• ////JE)A1))1101 \ Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: / //e/, / -P Original Certificate Date: g -/ 0 — 0 ci (Rev. 1L05) A. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST USS 3042 LOT 1B Parcel ID: 075t/32-8 Legal Description: WELL DATA Well type PRNATE If A, B, or C provide PWSID# N/A Date completed 5/30/97 Sanitary seal (YIN) YES Total depth 80 ft Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: /VICE ug./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size gal. Number of Compartments _ Foundation cleanout (Y/N) _ Depression over tank (YIN) _ Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft'orft'/bd System type Length ft. Width ft. Gravel below pipe Total depth ft Eff. absorption -a_ ft' Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in abso • '•n field before test _ in Water added __.gal. New depth in. Elapsed T _ min. Final fluid depth_ in. Absorption rate >= g.p.d. Cased to 80.14 ft FROM WELL LOG 5/30/97 59 ft Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 7/24/09 58 ft 25 g.p.m. 4.12 g p m. NitratcD.3'$ mg./L. Date of sample. 7/24/09 YES YES 18+ In Other bacteria 0 colonies/100 ml. Collected by: GEC Ltd. PUBLIC S EWER Date installed Cleanouts (YIN) High water alarm 6 ft. rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date D. LIFT STATION Date installed "Pump on" level at In. Datu Size in gallons Manhole/Access (Y/N "Pump off" leve - High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: N/A Septic tank/lift station on lot Absorption field on lot Public sewer main N/A 75'+ Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Water main Water service line Surface water Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIEL PUBLIC SEWER Absorption field Property line Water service line C rain F. COMMENTS Buil OT TO: undation Water main Surface water Driveway, parking/vehicle storage • Wells on adjacent lots G. ENGINEER'S CERTIFICATION 1 certify that I 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. Engineer's Printed Name JEFFREY A. GARNESS Dat©; *VI /o9 .. OF F� COSA Fee $ yqo Date of Payment Receipt Number (Rev. 11/05) R -7-o7 0 elg 2 Go Waiver Fee $ Date of Payment Receipt Number �G9 SGS RcG! Client Name Project Name/p Client Sample 1D Matrix 1093651001 Gamess Engineering Group, Ltd USS 3042 LIE USS 3042 LI B Drinking Water Printed Date/Time Collected Date/Time Retched Date/Time Technical Director 08/06/2009 16:55 07242009 14:50 07/24/2009 15:33 Stephen C. Ede Sample Remarks: Parameter Results Units Method Allowable Prep Container ID Limits Date Analysis Date Init Metals by ICP/MS Arsenic Waters Department Total Nitrate/Nitrite-N Microbiology Laboratory Colony Count Total Coliform Fecal Coliform ND 5.00 ugn. EI'200.8 C (<10) 07/31/09 08'03/09 NRB 0.368 0.100 mg/L SM20 4500NO3-F E (<10) 0 0 0 col/100mL SM2092228 col/100mL SM20922213 col/10OmL SM2092228 A A A (<200) (<1) (<1) 0728'09 LCE 0724/09 DLC 07/24/09 DLC 0724/09 DLC Page 1 of 1 Sonja Garness From: Brian Wille [brian.wi le1 @gmail.com] Sent: Friday, August 07, 2009 12:48 PM To: Sonja Garness Subject: Re: Concerning 118 Monarch Mine Rd. 1, Brian R. Wille extended well casing _14" at 118 Monarch Mine rd, Girdwood.AK. on Op062009.' On Fri, Aug 7, 2009 at 8:49 AM, Sonja Garness <Soniaaeamcsscnaincerine.com> wrote: Hey Brian! I was wondering when you get a change if you could email me a copy of the receipt for the work you did on 118 Monarch Mine Rd. Thank you! Sonja 8/7/2009 1