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HomeMy WebLinkAboutNETTLETON ACRES #1 LT 3Nettleton Acres Lot ! 5-06 -64  O Municipality of Anchorage Development Services Department ;:~ Building Safety Division On-Site Water and Wastewater Program, 4700 Elmore St. ~ P.O. Box 196650 Anchorage, AK 99519-6650 Page / of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: ~oO0t40 7-'~?5- PIDNumber: Name: Address: f~'[ ~ ~' '~ C~,. U~L [I "~ ~ Wastewater System: [~.J'qew [] Upgrade cr ?_ ~ o h( ~'/¢ (','~-,, Ov,~ ABSORPTION FIELD Phone: Number of Bedrooms: "~..--~.. ~ ~'~ (.~¢~'~ [ q ~ Deep Trench D Shallow Trench ~ Bed ~ Mound ~ Other: LEGAL DESCRIPTION Soi~ Rating: Total Depth from original grade: ~t ~ GPD/Ft2 /~ Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: Township: Range: Section: Fill added above original grade: Gravel Length: Well: ~New ~ Upgrade e~.~ ~id~h: Number of lines: Distance between Ii .... ~ ¢ Ft. ~ .... Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: * Date Drilled: Static Water Level: Installer: Date Instated: Yield: ADove Ground: ' GPM Pump Set at: Ft. Casing Height ~0 ~~ '~r( Ft. TANK SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. ~ Other: TF~ Septic Absorption Lift Holding ~/Private ~wa~ufac~urer: Capac~(y: Tank Field Station Tank SewerLine ~ ~ ~. ¢~0 G~,. Well l~ [~ ] ~O ¢ ~ ~ /O~ t~ S ¢'~( Number°t C°mpartments: SudaceWater '~01' /0'I~ ~ ~ ~ LIFT STATION in./"~ in. Remarks: ~¢ ~ ¢¢'~ ~ ~ ~ ~ ~'' ~ Looasonano uescr, pt,on: BENCH MARK Inspections peRormed by: ~[ ~, Dates: Ist ~/q ~¢ ~, O~ ~¢ Development Services Depa~ment Approval ~ ~ "4~TH ~"; ~'- ~. -~ .z~- .~ .... .... Con ,on , Reviewed and approved by: ~'l /~/, te: '7" / 'j/ t'tB~***~*""*'-~ Permit No. SW040295 Page , Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744 On-Site Wastewater Disposal System and/or Well Inspection Report 2 of 2 Legal Description: LOT 5 NETTLETON ACRES #1 S/D MARK FCO C02 TC01 TC02 305 C04 C05 C06 MT1 MT2 C07 C08 ~T5 ~4T4 25A 55B 64 75 64 74 68 182 69 85 69 84 74 1105 60 110 74 105 61 Illl 105 141 80 112o 90 158 103 144 99.8 196.2I 98 194.081 / ~6~=rL I / 95 191.7I / 95 191.6 I / 89 186 I / ~__._~______ / 10' T. & E. EsM'r, 87.51 84.3 I / -- 88.6 / 84.3 I 88.71 I I 87's/ I \ FCO \ TH#2.. / / / / TH#I/ I · \ / \ / TC 01 :02 / CALVE \ SECONDARY SYSTEM, S 89"59'22"E 230.00' PID No.: 015-062-64 \ \ ] / / / / NCH. TOx~_pF SLAB ASBUILT SCALE: 1"--50' SEPTIC SECTIQN N.T.S. -17 R~ 7~ FROM :Alpine Drillin9 FAX NO, :90?..345 0202 Jun. 2? 2011 ll:39AM ALPINE DRILLING & ENTERPRISES Permit Number: #SW040295 Date of Issue: 7-27-04 Date Started: ~-12-05 Date Completed: Legal Description: Property Owner Name & Address: Parcel Identification Number:~ is well located at approved permit location? [] Yes [~ No Nettleton Acres #1 Lot ;3 Nato Lavalley 9240 Nettleton Drive Anchora~le, Alaska 99516 Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To stick-up 0 2 organics & silt 2 4 gravelly silt 4 9 silty'gravel 9 43 gravelly silt 43 68 cobbly silty gravel 68 94 silt 94 90 gravelly sanely silt wet 90 124 silty water sand & gravel 124 127 Method of Drilling [-~ air rotary [] cable tool Casing type: steel Wall Thickness: .250 inches Diameter: 6 inches Depth: 127 feet Liner Type: ~ Diameter: ~ inches Depth: _ Casing stickup above ground: ~2 fcct Static water level (from ground level): 99 feet Pumping I~el: f25 fcct afl~ _2 hours pmnping 20 gpm Recovery Rate: 2_.q0 gpm Method of Testing: air lift Well Intake Opening Type: [] Open End [] Open Hole [] $~.-re~n~ Start __ 'fe,t [] Perforations Start~ feet Stopped ~ :feet Stopped feet Grout Type: betonite granules Volume: / Depth: $~a 0 fe~.t Stopped .9 feet Pump: Intake Depth __ feet Pump size __ hp Brand Name Well Disinfected Upon Completion? [~ Yes ['-I No Method of Disinfection: chlodne tablets Alpine Drilling & Enterprises PO BOx 110496 Anchorage AK 99511 Comments: Well Dffiler: Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 198850 Anchorage, AK 99519-6850 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency COSA# O.~D._~ Expiration Date: _ /' ~ /-i/ Day phone ~ ?--'-~" ~' $ ~ ! Day phone Mailing address Real Estate Agent 2. NUMBER OF'BEDRO"oMS~,; . 3. TYPE OF W.~¥ERSUpPLY: Individual We.l! :... · Individual Water'Storage Community Class ~ Well Public Water System Day phone Mailing Adar.~S's,:' ::'..,,-, Unless ~6'therwise requeste¢ ~GOSA will be held by DSD for pickup. TYPE OF WASTEWATER DISPOSAL: Individual On-site ~ Individual Holding Tank' [] Community On-site [] Public Sewer [] L II I The Municipality of Anchorage Development Services Department (DSD) issues Cedificates 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 System's 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 upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for propedies served by a private or Class C well and may be reissued with new water sample results. (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 theprofessional 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 obtain'ed from the Municipality of Anchorage files and from my 'investigation and inspection, the on-site water ~upply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State code~, ordinances, and regulations in effect at the time of installation. Name of Firm /"/I ~¢~' Address L4~L~ ~! /,,L,~ Engineer's Printed Name DSD SIGNATURE '!/ Approved for Disapproved. ¢6, Phone "~ "~ Date 5 '~ MICHAEL N ANDERSON ~,,~.. cE~ bedrooms. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Rev. 11/05) X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other ~ Original Certificate Date: '7~ /~ // Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST LegalDescription: )~] ~")~'/.~ ~,'r,~ ,~f /-o b- '~ A. WELL DATA Parcel Well type Date completed Total depth ,( '~ ,';z ft. IfA, B, or C provide PWSID # . Sanitary seal (Y/N).. ~' Cased to .. ( 3_ ~- ff. ./ Well Log (Y/N) y Wires properly protected (Y/N) ~ casing height (above ground) z. L,, in. Date of test Static water level FROM WELL LOG AT INSPECTION Well production ~,...0 g.p.m. WATER SAMPLE RESULTS: Coliform ~. colonies/100 mL Nitrate 5"~[ mg/.L Arsenic: SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size [ ?..~"0 gal. Foundation cleanout (Y/N) Date of pumping Number of .Compartments Depression over tank (Y/N) Pumper ,~r,~ C. ABSORPTION FIELD DATA Date installed ~/'~'~/~.1' Soil rating Length ,,, ~' '~ Total depth t! ft. Date of adequacy test g.p.m. Other bacteria 'colonies/100 mL Collected by: ,A4~ Date installed. Cleanouts (Y/N) High water alarm (Y/N) (g.p.d./ft2 or ft2/bdrm). ft. Width ~, ~ ft. Eft. absorption area/~,.,~5/ft2 Monitoring tube ~'/1~// Results (Pass/Fail) Fluid depth in absorption field before test ~ in. Water added '~"~'Oga¥~'l. Elapsed Time:/'¢~'nin. Final fluid depth __~ in. Absorption rate >: Any rejuvenation treatment (past 12 mo.) (YIN & type)! System type Gravel below pipe ~, t9 ft. Depression over field ~ For .. ~' bedrooms New depth..~ in. 7~ 7/- g.p.d. If yes, give date D. LIFT STATION ' Date installed Size in gallons ~Y/N) "Pump on" leve~n. High water alarm level at Datum ~ Cycles tested Meets alarm & circuit requirements? in, E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: I SePtic tankftif#etetion on lot Absorption field on lot l(~o ' -/-- Public sewer main ~ Sewer/septic service line Animal containment areas / On adjacent lots / ~ o'/. On adjacent lots / c~ o '-/. Public sewer manhole/cleanout /~- /,x~, Holding tank /'4/.,,~, Manure/animal excrete storage areas /~o SEPARATION DISTANCES FROM SEPTIC/~ TANK ON LOT TO: Building foundation ~- C) ~ -/- Property line Water main ~ /,,~ Water service line / u~o t~_ · Wells on adjacent lots ! 49o Absorption field Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 7~O ~ ~ Building foundation ~' ~ /h/- Water main Water Service line Curtain drain ~~, COMMENTS G. ENGINEER'S CERTIFICATION Surface water /~o ( ~ Wells on adjacent lots z~ e t./_ ! Driveway. parking/vehicle storage '7.. E) ~-- COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) I 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 Date ~~ l~ 7 o'1o Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # 111231 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 3 of Nettleton Acres #1 subdivision. This inspection revealed a nitrate concentration of 5.7 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. SGS Reft# 1112756001 Client Name Mike N. Anderson, P.E. Printed Date/Time 06/30/201 I 16:50 Project Name/# 9240 Nettleton Drive Collected Date/Time 06/27/201 I 12:05 Client Sample ID Water sample Received Date/Time 06/27/2011 12:20 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits [)ate Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 06/28/11 06/29/11 NRB Waters Department Total Nitrate/Nitrite-N 5.71 0.100 mg/L SM20 4500NO3-F B (<10) 06/30/11 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 06/27/11 SDP Total Colifbrm Negative 1 100mL SM20 9223B A 06/27/11 SDP PLAT NO. 92-114 NETTLETON ACRES, UNIT NO. 1 LOT 5 50,600 S.F. o o z 50,0' SEpT,C SYSTEM S 89°59'22"E 230.00' WELL 39.6' ~ EXISTING BUILDING 101.0' S 89°59'22"E 230.00' z 50' Ld Z 1 "=30'  '---- DRIVEWAY ENCROACHMENT FROM LOT 5 AS-B U I L T , HEREBY CERTIFY THAT I HAVE SURVEYED THE ' ' PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, 2000 E0 DOWUNG RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR 2439 5/28/2010 ESTABLISHING BOUNDARY OR FENCE LINES. ' ' ANCHORAGE RECORDING DISTRICT, ALASKA F.B. JOB NO. NOTE: NO CORNERS SET THIS DATE. 10-02 NAS 1,5 Mayor Mark lhyfich unieipality of Jh d Ol ¢ 77' i June 13, 2005 Nate Lavalley 9240 Nettleton Drive Anchorage, AK 99507 Subject: On-Site Water and/or Wastewater Permit. Permit Number: SW040295 Legal Description: Nettleton Acres # 1 Lot 3 Dear Mr. Lavalley: An On-Site Water/Wastewater Permit, number SW040295, issued by this office for a single-family system, w~ll expire on July 27 2005. The permit is valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as-built inspection report must be sent to this office for review, approval and documentation. This as-built inspection report must be signed by the licensed Professional Engineer who inspected the installation ofthe system. As-built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit for a second year may be issued for a fee of $115.00 if the renewal application is received on or before the' expiration date of the original permit. When applying for a new permit, the fees are: $460.00 for a wastewater permit and $175.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincerely, Daniel J. Roth Program Manager On-Site Water and Wastewater Program Enc: Copy of permit Corn m unity, Security, Prosperity MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Ancho~'age, AK 99519-6650 (907) 343-7g04 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Jul 27, 2004 Expiration Date: Jul 27, 2005 Permit Number:. SW040295 Parcel ID: 015-062-64 Legal Description:[_N,E~_~l'ON ACRES #1 'SUBDIVISION LOT 31 Design Engineer: 0014 Anderson Engineering Site Address: 9240 N I=I I LETON DRIVE Owner Name: NATE LAVALLEY Lot Size: 50600 SQ. FT. Owner Address: 9240 NI=ii LETON DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99507- This permit is for the construction of: [] DisposalField [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Ail 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and dosed on the same day. B. Covered. sealed, and heated to prevent freezing. Received By:. Issued By:, Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SW Property owner(s) ,~4.~,/~ Mailing address (1) ~ Mailing address (2) ~ ~~ Legal description (Lot, Block & Sub'd.) Legal description (Section. Township & Range) LotSize ~o/ ~o~ Acres/~. Day phone Zip Code ,'~'~D-~ -~- .! Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Well Only [] Water Storage [] THIS PROPERTY CONTAINS: Hot Tub [] Jacuzzi [] Swimming Pool [] Water Softening Unit [] Therapy Pool [] I certify that the above infor~,n~,,,tion is correct. I further certify that this application is being made for a Single Family Dwelli~j~a, ccordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Dateo1Payment: Receipt Number: (Rev. 1~0) Waiver Fees: Date of Payment: Receipt Number: Michael lq. Anderson, P.E. Civil/Structural Engineering 4640 Shoshoni Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 July 20, 2004 Municipality of Anchorage Department of Health and tiuman Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Re: Lot 3 Nettleton Acres #1 To Whom it may concern: This is a request for a new septic & well permit for the above residence. Two test holes have been excavated to 17 feet for verification ofthe soil types, only one was perced. The second test hole was silty sand (SM) and poorly graded sand (SP) at different levels. The perc was done in the slowest material, SM at elevation 6.5 feet and found to be 15 minutes per inch. No water was observed during the test hole excavation of after the 7 day monitoring period. A deep trench system has been designed with an application rate of 0.6 gpd/sqft. The trench length is 62 feet with 8 feet of effective depth fora total depth of 10 feet, per the drawing. All drainage is to the southwest at about 3 to 5 percent. This new system will not impact the neighboring properties due to the large lots and layout of the existing systems and well as the plan shows. If you have any question please call me at 345-3377 Michael N. Anderson, P.E. ~..".~. ~......-..~ ~n~[n~tln~, [n~, ~(ml}Z~ mB NO.: 04701DAIE:)RA%~: 7/19/04NEL DE~: ~NA CKD.: UNA ~., SH[ET D I= N A I I 2;39 ~ ,s,~, A~,,~ ,~, ~_~ . ~cherage, ~s~o. 99516 engineering, nc. ~.;,~ ~.0.: 04701 DRAVf?~:0AI[: 7/19/04NEL D[DCH: ENA C~D.: DESIGN CRITERIA: 4 BEDROOM X 150 : 600 GPD APPLICATION RATE: 0.6 GPD/SO. FT. USING 8' EFFECTIVE DEPTH DEEP TRENCH 1000/(2 X 8') = 62' FEET TRENCH REOUIRED TRENCH: 11' DEEP 8' EFFECTIVE DEPTH NOMINALLY 20" WIDE (1) 62' LONG ......--MDUND DVER (TH,I) -2 -- rlRG ~__ [.....-..-FILTER FA]~RIC SM -3.0--: ...----4°4 PIPE I SP - ~SEVER RDCK -I.1.0-- -- SV -1.7 __ ~,."9" ~, -'-?t", ~DETAILS - NET~ETON ACRES engineering.. ~(.~ Jm ,o.: o,zo, o.~,:>,.~,.: 7/,9/0,.~L ' DE,ON: MNA CKD.: ENA .......... i Municipality ot Ancnorage Develo ment Semites Department I ~. TH~ P O Box le66~ ~om~. ~ 9951~66~ I ' ' ~ d~nche~e.~ us Soils Log- Percolation Test ' SIo0e S;te Plan 10- 11- 12- 13. 14- 15- 16- Reading Dale Gross Tone Net Time I Deplh to WaterNet Drop /V/' ~,Z'~ 0 ~' ~ I ~" ~,, · ~ P poo,-I~ wAS GROUNDWATER ENCOUNTERED? ~C) L IF YES. AT WHAT DEPTh? 0 18- 19- 20.