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HomeMy WebLinkAboutCINERAMA TERRACE BLK 1 LT 5Ci'*nerama Terrace Block 1 Lot 5 #020-521-04 Municipality of Anchorage Page 1 of 3 Development Services Department Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO50447 PID Number. 020.521-04 Wastewater System: Upgrade J m Dyer P.O. Box 231029 Anchorage, AK 99523 ABSORPTION FIELD Four 5' Wide Trench 223 6389 LEGAL DESCRIPTION fid Rrvq: Taal Dean barn wVml Qsds: 3 .8 GPDIFP Ft. 8w La: ti.ebwuon: Dp0 top" Eaba lnrn agml g, 0 Cxawl d.m t v pts'. 1 5 Cinerama Terrace 2 Ft. 1 FL To-ww li-" Sstlan: Fit eddsd soo.s argr Vada. Drell LOVft 2.3 Ft. 132 FL Well: Existing rwaw.gtn. 5 rMnosr a r .. 2 Dress estwan r 10 FL FL cluadivaon (Pn . A B. c[ 7" DoW: Grid b: olal ab.[X an rw P Mlle Fl. FL 759 Fe ASTM 3034 PVC Dr . Das 0 e Sts¢ Was Le FL A Plus Home Services 6119-2212006 ."" P" sw.L casesH&vtAls : TANK GPM Ft. Ft SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Ftonl I Absorption Field Lilt Station Holding Tank tibDHPrivate Sewerune Anchorage Tank 1,250 w.L >100, WA WA >25' x Steel Two (2) s..ro w.ta 9>5' >100' WA N/A LIFT STATION — NONE ON LOT La Low 1' WA WA cd. Fwtlras >5' >10, WA WA ti in h None Noted PGTA= Mad./ �sarvlY.W.a,mapwt«neq w. C~Dr R«asrb: BENCH MARK bee Lot Line waiver. Sisting Septic Tank Removed From Site- Insulation Place,' OveFTMk, was Pumpea an Pipin"AA saw Concrete Porch Slab 100.0 FL Absorption Trenches. Engineer's Stamp •••••.tLeupa OF A,� a 40 Cep .....l� • �• Inspections performed by: AH Dates: 1° 6119106 1 49:h /� i 2nd 6122106 ��°��" E. A8JC45CA: Department of Health and Human Servi es approval Reviewed and approved by: Date: %— % aasasPRCji rxa toval .-SS .•. Municipality of Anchorage \ DEVEOPMENT SERVICES DEPARTMENT 1 4700 South Bragaw Street Anchorage, AK 995195655 - 343-7904 Onsite Wastewater Disposal System or Well Inspection Report 61 390 }l5 6l �1J •15 YI !1I W 1157 15, U 515 me CS IM, M+ a 595 49+ Cr 1151 n l- av b5 M.r CINERAMA TERRACE SUBDIVISION LOT 5, BLOCK 1 137.179 S.F. 49th ° MICHAEL E. ANDERSON No. CE -4361 . Page 3 of 3 Permit No. SW050447 PID No. 020.521-04 \ \ 4 \ sATELLrrE \ DISH \ rE \ \ if FENCE (AP%)\` _ C�t'El DRNE * J N X306 PLAN AS -BUILT SCALE I' - 60' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage. AK 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SWO40199 c � m d L M d Page 3 of 3 PID No. 015-05420 NORTH LEG 99.3 U s 96.5 v 93.1 i-1 11 Drelnfleid Rock 92.0 66' (Trench Length) SOUTH LEG � i 49th PROFILE AS -BUILT '�``"`°"�`"381 ' 0, No i No. Q-1]91 No Scale '•_T �i�0•(,;� f MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot 5. Block 1. Cinerama Terrace Subdivision PERFORMED FOR: Jim Dyer DATE: 6/19/2006 PROJECT No.: PARCEL ID#: 020-521-04 TECHNICIAN: A. Harala DEPTI I (r«q TEST HOLE # ](A] GRASS/ORGANICS SANDY SILT WITH GRAVEL ML a— fm SLOPE GROUND WATER ENCOUNTERED? Yea SITE PLAN SEE SITE PUN a IFYES®WIIATDEFnI? 12' p� DEFTN®MONITORING 9. 5� DATE OF MONITORING. 6 26 06 DATE READING GROSS TIME (MINUTES) NET TIMEJ (MINUTES) Dy ATERE (INCHES) NET DROP I (INCHES) 6/19/06 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 10:08 7.88" 2 10:38 30 5.5" 2.38' 3 10:39 8.25" 4 11:09 30 6.00" 2.25" 5 11:10 8.13" 6 11:40 30 5.93" 2.20" PERCOLATION RATE 1�(MIN/INCH) PERC. HOLE DIA. 6 rINCHES) TEST RUN BETWEEN•3,Q_FT. ander QFT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT TIIIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 7!1/2006 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX MEMORANDUM DATE: July 3, 2006 TO: Joe Goodall FROM: Mike Anderson, P.E. SUBJECT: Lot 5, Block 1, Cinerama Terrace Subdivision Septic System Construction Permit No. SWO50447 The owner of the subject lot has requested the septic system be upgraded to 4 bedrooms. We have revised the system design to accommodate his request. A new 1,250 gallon septic tank will be placed along with two 66' long x 5' wide x 1' effective depth absorption trenches. A lot line waiver allowing the trenches to be within 1' of the lot line will be required. The new configuration will eliminate the requirement to demolish the existing system and result in a much cleaner project. The existing septic tand will be pumped, crushed and either backfilled or removed from the site. The existing absorption trench will remain in place for possible reuse. We originally called in the request to modify the system on June 19. The attached documentation is to follow up that conversation. 0 CINERAMA LOT 49th.•.; MICHAEL E. ANDERSON No. a4xi 11F Lot TERRACE 5, BLOCK 40.000 S.F. O TH SUBDIVISION 1 2-66' Long x 5' Wide x 1' Effective Depth Absorption Trenches Flow Home 000, SITE PLAN SCALE 1"= 40' LOT 5, BLOCK 1, CINERAMA TERRACE SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: 6 a R.- Fhm Bedroom House stem Perc. Rate: 6-15 Min./Inch ��/,2� WIon Septic tic Tank Application Rate: .8 GPD/SF Vrainfield Rock 70 t4 ,eBedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 6e2.5 SF Absorption Area ' 5*&k.-,XSF/5 LF (Width)' .87(Red. 66Fa ctor) =47-0 1_17 Trench Length THEREFORE: _TfeneheeAd-Construct 2 NewX x � aLong 'Wide x 1' Effective Depth Absorption Trenches. Flow Line Elevation in Trenches to be 2' Below Original Ground Surface. Total Depth to be 3' Below Existing Ground. Place 2" of Insulation and 2' of Cover Over Absorption Trenches. Provide Flow Splitter Valve to Assure Even Flow to Trenches. Place Topsoil ---and Revegetate All Disturbed Areas.—____.__—_...__.._. 1'6" I I Natural Backfill 6" 1'0" Place Topsoil 8 Revegetate Disturbed Area 2" Insulation 8 Geotextile Fabric 4" Perforated PVC (Holes Down) Drainfield Rock TYPICAL 5' WIDE TRENCH SECTIO"' (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Welts in the Area. Minimum 100' Separation From Surface Water or Streams: ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX MEMORANDUM DATE: July 11, 2006 TO: Jeff Poet FROM: Mike Anderson, P.E. SUBJECT: Lot 5, Block 1, Cinerama Terrace Subdivision Final Septic System As -Built The placement of the new absorption trenches at the location shown on the as -built drawing resulted in not having to demolish the existing absorption trenches. No contaminated material was encountered and none had to be disposed. In addition a flow diverter valve was placed to allow use of the existing absorption trench system in the future if it should become necessary. Please let me know if you have further questions. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SWO50447 Legal Description: CINERAMA TERRACE BLOCK 1 LOT 5 Design Engineer: 0014 Anderson Engineering Owner Name: JIM DYER Owner Address: PO BOX 231029 ANCHORAGE. AK 99523 - Date Issued: Dec 06, 2005 Expiration Date: Dec 06, 2006 Parcel ID: 020-521-04 Site Address: 8705 CINERAMA CIRCLE Lot Size: 137179 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 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 closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. -MOA APPROVED SAND FILTER NEEDS TO BE ADDED TO REPLACE ANY CONTAMINATED MATERIAL REMOVED SO THE BOTTOM OF SEPTIC GRAVEL IS NO DEEPER THAN 3 FEET FROM ORIGINAL GRADE. PLEASE INCLUDE THIS INFO WITH AS -BUILT INSPECTION REPORT. -THE BOTTOM OF GRAVEL FOR BOTH SEPTIC FIELDS MAY BE NO DEEPER THAN 3' FROM ORIGINAL GRADE. -AN ADDITIONAL TESTHOLE WITH PERC TEST AND GROUNDWATER MONITORING NEEDS TO BE COMPLETED DURING CONSTRUCTION AND SUBMITTED WITH AS -BUILT INSPECTION REPORT. Received By: Date: Issued By. r6Z v Date: L 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.enchorage.ak.us (907)343-7904 ' ON-SITE SEWER/WELL PERMIT APPLICATION RI FOR A SINGLE FAMILY DWELLING Parcel I.D. C?D — Jd 1- 04 Permit Number SW Property owner(s) Jim Dyer Day phone 223.6389 Mailing address (1) Pb 'I3(r( Ay o -' ?q A Mailing address (2) 8705 Cinerama Circle AIA Zip Code cP571, Legal description (Lot, Block & Sub'd.) Lot 5, Block 1. Cinerama Terrace Subdivision Legal description (Section, Township & Range) Lot Size 13-4. l qq Acr s/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Three (3) Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade El THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: ArWo 1:1— t/TS 1 Rus j4 Waiver Fees: Date of Payment: l z_/S- f D S Date of Payment Receipt Number. Receipt Number. (Rev. 12100) —�� ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 622-7773 677-7766 FAX December 4, 2005 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 5, Block 1, Cinerama Terrace Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing absorption system on the subject lot has failed and must be upgraded to obtain a Certificate of Health Authority Approval on the property. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing septic tank, existing absorption area and the proposed absorption area. Also identified on the plans are the locations of the existing well. No conflicts exist between the proposed septic system and the wells on adjacent lots. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. Very little area is available on the lot for the septic system due to the presence of surface water to the east and to the north. The only available area is located at or near the existing absorption area near the west property line. We are therefore proposing to reconstruct the southernmost trench on the existing absorption system and construct a new absorption trench 10' to the south of this trench. All pipe, insulation, drain field rock and contamination will be removed from the trench and buried on site at the location shown. The existing septic tank has been uncovered, inspected and verified acceptable for continued use. Tobben Spurkland and James Sizemore placed several test holes on the lot at or near the location of the new absorption trenches during the construction of the original septic system in 1991. Their test hole logs indicated silty gravel or gravelly silt with percolation rates at 13 minutes per inch. The location of the test holes along with the surface elevation at their respective locations is shown on the attached site plan completed by James Sizemore. A recent test hole completed on the property and identified as THA on the site plan indicated similar gravelly silt materials found in the holes completed by Loi 5, Block 1, Cinerama Terrace Subdivision December 4, 2005 Page Two Sizemore and Spurkland. The test hole was completed to 13' below the surface with seepage noted at 12'. The groundwater rose to 8.8' below the surface during the monitoring period. We are proposing to utilize the existing 1,000- gallon septic tank and construct 2 — 50' long by 5' wide absorption trenches with 1' of gravel beneath the distribution pipe as previously described. The distribution pipe in the trench will be placed at 2' below the surface with the total depth at 3'. A Flow Splitter Valve will be placed to assure even flow to each of the new trenches. The ground surface on the lot slopes to the northwest at a grade of nearly 15%. The new trenches will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from the existing well and any surface water in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, M"' -L zat---� Michael E. Anderson, P.E. WCNA[E E. AND[NSON 4 No. CE -4301 Attachments 95 702.77 75E 24 9 Z E r 5 s GODO OF g n p p� ri 6 O '"jS' rayl f1e1 azo e fy'6 �f J.y,g�7f 6 5 gyp. . ................. • AREA MAP �... �.YICIVEL E,M�FJISON •mak., "���'°' : � � SCALE 1" =100' f b \Rr� '„awed Noxa ff. Remare NI Pipe. Iruula5an. ay"�y irk \ Rack 8 Cantemmetian Fmm Three Beft0m \ E)d rt9 Southanxnaet Tmr h. Canstnwt 2 New 50' Long x 5 None \ ton Trend \ Ew.ker�a'• \ Gmwar^"'N \\ %cc\e ��P� .......,, ••� Gin ° 49th„ � '.� . •............._. --, SITE PLAN �1i iMiCIMELE MOEXSd1 f � 1 No cE t f i •�... , yT r=ur J�yC'•t SCALE 1" = 50' LOT 5, BLOCK 1, CINERAMA TERRACE LOT 5, BLOCK 1, CINERAMA TERRACE SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom House 5' Wide Trench System Perc. Rate: 6-15 Min./inch Existing 1,000 Gallon Septic Tank Application Rate: .8 GPD/SF 1' Drainfield Rock 3 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 562.5 SF Absorption Area 562.5 SF/5 LF (Width)' .87(Red. Factor) = 97.8 LF Trench Length THEREFORE: Remove All Pipe, Insulation, Rock and All Contaminateion From Existing Trenches and Construct 2 New 50' Long x 5' Wide x 1' Effective Depth Absorption Trenches. Flow Line Elevation in Trenches to be 2' Below Original Ground Surface. Total Depth to be 3' Below Existing Ground. Place 2" of Insulation and 2' of Cover Over Absorption Trenches. Provide Flow Splitter Valve to Assure Even Flow to Trenches. PlaceTopsoil and Revegetate All Disturbed Areas. 1'6" 6" 1'0" Natural Backfill 5' Place Topsoil & Revegetate Disturbed Area 2" Insulation & Geotextile Fabric 4" Perforated PVC (Holes Down) Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. j Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. Minimum 100' Separation From Surface Water or Streams: No. CE4381 Ci La �r ,i. ce ...... ri1 L L_i- -7- 77— L '1-71 a Tt- -14-1 �- 777 .}. I I 1 1 1 1 f•� � -T�- Ta-T J � I ._ f � �e i- --♦-�� ' J_� -I. '_._'—� L - � I. � �! I I 1 I I ! I � T� - rel—.T_-r �� � I•-{ — ! 1—� � •- L_.r1 Q LLI 1_• .{ 7 T- - 177 -' , I' I I ' II I .i--.''- � 1 L ' ' J 1 _ �' Iii ! r L '- � L � I i t •,: , � I ~ . I I�I I L L—� •-� I• I �. I I I- I��1J-L i -1' i rrrrrrrrrrrrnrrrrru MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (r«q 1- 2' 3 4 5 6 7' 8 9 10 ]1• 12' SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION. Lot 5, Blockl, Cinerama Terrace Subdivision PERFORMED FOR- Jim Dyer DATE: 11/21/2005 PROJECT No - PARCEL ID#' TECHNICIAN: A. Harala TEST I IOLE # 1 OG/OL Sandy Silt With Gravel ML 13BOH 1 1 1 1 1 1 WAS GROUNDWATER ENCOUNTERED? Yes See Site Plan IFYCS®WHATDri'fir I2' I See Site Plan DFPTII OF WATER AFTER MONITORING: 8.8' DATE OF MONITORING: 1213/2005 G ATER OSS TIME NET TIME WF NF�T DROP DATE READING MINUTES) (MINUTES) (INCFIES) (INCHES) PERCOLATION RATEi_(MIN/INCII) PERC. HOLE DIA`(INCHES) TEST RUN BETWEEN_ FT. and FT. COMMENTS: TEST HOLE COMPLETED TO DETERMINE GROUND WATER TABLE. TEST PERFORMED BY ANDERSON ENGINEERING SOILS TECHNICIAN. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 12/4/2005 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 5, BLOCK 1, CINERAMA TERRACE SUBDIVISION GENERAL: 1. The scope of this project includes the work to remove the existing pipe, insulation, drain field rock and all contamination from the existing southernmost absorption trench. All contamination to be buried on site at the disposal area shown on the Site Plan. Work will then include the reconstruction of the existing trench and the construction of a new absorption trench each 50' long by 5' wide by 1' effective depth also at the location shown on the Site Plan. The total depth of the trenches Will be 3' below existing ground and the distribution pipe will be placed at 2' below the surface. All components of the new absorption trenches must be constructed a minimum of 100' from any surface water and 100' from the well on this and adjacent lots. A minimum of 4' of cover is required over the septic tank and 3' over the absorption trench. In lieu of cover 2" of direct bury insulation and 2' of cover may be placed. A Flow Splitter Valve must be placed to assure even flow to each of the new trenches. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor is also responsible to assure the separation distance from wells and surface water in the area is maintained. The engineer will accept no responsibility for Contractor errors. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. Lot 5, Block 1, Cinerama Terrace Subdivision December 4, 2005 Page 2 of 4 SEPTIC TANK INSTALLATION — NOT REQUIRED The existing 1,000 -gallon septic tank has been uncovered, inspected and verified suitable for continued use. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of levet. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class Lot 5, Block 1, Cinerama Terrace Subdivision December 4, 2005 Page 3 of 4 "C" Well or 200' from any community well. The Contractor is solely responsible to assure these separation distances are met. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections must be completed during the construction of the septic system. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not Lot 5, Block 1, Cinerama Terrace Subdivision December 4, 2005 Page 4 of 4 be backfilled. The Contractor must notify the engineer 4 hours prior to the inspection to prevent delays. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. His measurements must include verification that the proper separation distances have been met. A certified surveyed as -built may also be required to assure the proper separation distances are met from wells in the area. The as -built will also include separation distances from streams or surface water in the area. i Fes) 1 G I^o and � E le V.: =1979---,� y ?� Sha111OwTra c4-' til Ohm 5x35 gy R P l a C --e- V1,76t A`35tje,C cl E.leV SW i_,U-iJ LOGci�C' On Shou.,Oct- c. No Dive f" �2 _..6 On �,-Dro nie, ,TV, +>�r •� i lsz,P i 5 � A �. Jornns F. Lu.':ao � 4. S 1 TC P PRC) P 0 Z FD0N- ► , s - SY=��"tel L5CINERri.- TEJ kACG _`,U,; ��: J �,-Dro nie, ,TV, +>�r •� i lsz,P i 5 � A �. Jornns F. Lu.':ao � 4. S 1 TC P PRC) P 0 Z FD0N- ► , s - SY=��"tel L5CINERri.- TEJ kACG _`,U,; ��: Municipality of Anchorage Page of .� DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SSI C/ /30/ 5 PID Number: _C)gQ—!p 'C& Name . s o Wastewater System: XNew ❑ Upgrade Addrop'O` O /!ZSx'1-8"- ABSORPTION FIELD Phone: No. of Bedrooms: p Deep Trench Shallow Trench ❑ Bed O Mound O Other LEGAL DESCRIPTION Soil Rating: ©i Total Depth lromorldinal grade: � GPD/S Ft. ' . Lot: r' Block: Subdivislo ' C�jJ�/c1i7/1A Depth to pipe bottom from original grade: �� ` Gravel depth beneath pipe .J d�iGCC O Ft Ft. Tow �ipA, Ran\ section/ Fill added above ofigina Gravel length: / / t Ft. WELL: fi(New ❑Upgrade Gravel depth: Number a�faitloe�ss: Ittance Drove/ephnex Ff. U� Ff. ihc'ayn (Private, A,B.C): CIr Prey f-6>_ Total Depth: Z�S Cased To: Total absorption area: Pipe material: P V <-- Z? Ft. Ft. SO Ff. Driller.at Date / / StaecWaterLl et. Date Inst led: q. lC/ ST - GtC 10112 f1 Yield:Pump set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES Nteptic ❑Holding OS.T.E.P. To From Septic Tank Absorption Fiala Gh station Holding Tank bliWrivate ower SLlries Manufacturer.CepaciI C)-�� �`�` In gallons: 4f:7d O Well t/�� 5 N/A !T AI/t ,V /i 8 1 lV Materiel: (LIFT Number of Co�enmenis: Surface Water tithe Wo STATIONG^ Lot�/ / O / Size In gallons: Manufacturer: Line Foundation `�, "Pump on" level et: otr' level at: High ware at: Curtain �� n A Pump odel Electrical Inspections performed by: Drain Remarks: Z./' BENCH MARK aUL,1 r Se F 7-c7 r;7 I—e.7C12 Location and Description: T f C /^ D Al -4- 190fir, e7— f Assumed Elevation: ENG`0((M'%JEAL \\I �� OF A q 1 Inspections by: Ja��S Sr ="Dates:ls l�) 0 H ;0 is s49L •�• ~•�•••• ` performed qd 4&d Z-3'- 0 7-5 �i3 2nd /'i tJG``� i ... .....: � t^ � James F. Sizemore 4W / 2—f 7 _ �� /��— Department of Health Hu 'a ices approva � 0-k aC 1577E +��'�y'••.,,••.••••..••���;� c 7 3 1,f4% 4 Reviewed and approved by. ate: %q:::e T2-013 (1101) MOA 25 Permit No. S W 9/ b 15 (o Page 21 of1— Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: L S S I G i "Tc_rraGe-_ PID No.: SV/ rRo � - S '111J ` 51x (9'fzA j J rifoUS e -K 41 . d ^ Ll e M psi' e(I B. M. Assu 61av, i E;7w iToP ExP06e'49�d �n LnSUf.eo carne/ Jgr; ve PL—km �J16W-1I0uSL FouN[)A i SE PT IG TAWf,, LEACH Fl F.L-D C,o'- _.... Ye7liEt-fU SEAL O Otr. A.qS+°C! •CQ .•' •. �f• 2 49L J �•* 0 R` : James F. Sizsliioro l� / �'• #1517E . .4p 00 2� fi4 arjF •• •• F ROFESSWN:�,�� 72017 A )R•..891) MOA 25 Permit No. 5W 9 Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: 5 8/ C- I /%c—rd/17ca I eq /29 r-_6�— PID No•:S W 91 C22 S6 V 1,757 RiCj Cl 8[7!e T45u�, Ash KIEV, Ho��£SO�So, �s on, rvbF} a No. Roca l f-:! V, So, CEJ �r i a 1474 `,i cf?;cf ZJ15u/ err I �V • M JD CSI.; E S Eb Ft 11AL r 06. QCE,..«...,� f E-1 14 2 i *'49L a.. Vie{ MN•N•N ,w •Wry IlL�{ Jamal F. Sizemore 4 2 40 i I e ELEV. O P\ T! 7 t,+i� •pROFESS1CNp���� 72010 A (2101) MOA 25 PAGE 1 OF 1 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 AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910156 DESIGN ENGINEER:JAMES SIZEMOORE & ASSOCIATES OWNER NAME:POMEROY SUSAN HOWLAND OWNER ADDRESS:PO BOX 112569X ANCHORAGE, AK 99511 PARCEL ID:02003308 LEGAL DESCRIPTION: CINERAMA TERRACE BLK 1 BK 5 SEC 1, T11N, R3W, SM LOT SIZE: 137179 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 6/17/91 EXPIRATION DATE: 6/17/92 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: 7v. Ps 3 ��� ' p �4 101o'` i�D :QLILOD d hv-j� DATE: DATE • 4 a^� e_ �\ w Se Pty B/ G;neidrz SYe2tda ;t, Cc: Mound Srorl ft"c.n bsm-f- eSCC�vaf%o�J 4rr�c.0 4eco I /J! ,'Zn-SUIZ7`%O12 EL 1475 ?" �l•14k2` (a, N tsi�* t � o" Se Wer !?oc/c f000Ga1.5Td/7,kr T; G"ovEr^ 2nsu /a f -c -K1 i+h Zrr <I »Sola E:or� TYFi ca / �a, 7trehu, /V ot-e cont-r,gGfor Sha// u✓'Y)is�i S�*--f1'c- -�Of2lr C/e,511) ©c,.-4 p�Pes D/^dim' i o ll!' T',1 e Mom i �o ri �? y P: PE 7`' d rL Co12JPIY tv r-th M4/'IiG- Pal fY o ��r1� 5�aric(o,-25 SY S�-C!�?S J�/fc10;!^ l9q ve.-,Sic�iJ "he, Shc7/lore tr'e�Gh�s ssem;// 6� f a 1d o cif- . I.c� i -f A). The !m c> e / 7'77e bO /}') 2-' b z° loci f`h Play?. There ShoU-o" o rlrJcl�s�urh�c{ �orl 6PX7 f!-2 -t-i^�vI c h es_ RECEIVED JUJI 16 1991 Municipalfry ct Anchorage Dept. Health & Human Services James F. Sizemore N 1517 E Lu J o c� rl Qr/y a5 S�a �PJ/1 o rj rt'r'�✓�Gh�S ��h �afC� OW/ wlYh �Id� YG,af� bo il-v&,a� -/-Aea 17r�.?�y 4o f/,w e-i?d �✓- �� �{�� �-i'�r�ch arm -L{J�s-F m� �h� lih e. -the -thG' SGJv�/lpcv ����?cGt�s Urth i�2e �ai /"oG e� a7Ch tl'l d f Sws� PLIC,-.) - Saa -iot) 8 L„L. 13 )-- — 3yS-9719 $Iv. r�...� /inr Ari ►pJ A u '11) \ 0 M . �\ T Ir• 1 F— le V., Sha /14\,.! Tro-hciv_- ...°. (fie PICC -e -vi -7&- � E( Ifdly r �ra � nays. �Srrlf. P��.OF •q�4s �} 49711 NI.NI•IIN�.1 •.N.N�.. James F. Vzomore •. # 1517 E 40 5 ov C orl)--j. ���� L cD On No on Su! Ounc�il7� LcS \ c J�t5o5 S -Ca /e , /'C 50 Pro PO.Sed WeI( 0 PRO W E LL:: 4 Sy. P T I C_ SYs �M L 5 E I -C ) N1=R .M.A TLij RAC_& -5USQ �•-- Pfil L S %• S*crr7 DE si'�� �.,5� � � G�/'I�i/�o'r>>d 7"��'race su6div�5�o� P��'� ��`�� = e� �r:•�/ire. � �� a S ha6lo cv T�'� 1 ile FO- r 5 O' P, ffo(�se , �lb�o/P�ir�� f(r�a Reyes,- �.��� -FIT T rEy%Gly { 9 MOA �° 9j� 5e el, V 5e I Tr'E d! �r�C' 4 Tie Bch x .A re a 6kckJ/1 I-/ V); ri r� i,` ,� =�OF .41_X11 rs��...••..:•..gs .9TH James F. Sizemore • y 1317 E �•� �V�.i �� AOFE551� G S%/ S -lcm Gi/-)e-r"-an-) a /I C,0. ci) IO bo �a1.5ePfic- T"/r Z,v,rl r�lsula,r� 1f coucr-� g} -/- e s '9, e e— . 6 C.D- fit iMcl)�fco- TtZt., ',✓;sem T rNOM `- I t --o, /f oc-,e-v be"e a7c'(7 Z21 -a;/7 6 Odle/' Gle ars ocr fPr Pel D/'Ji�I f `io/� � S�dr,�'�i�� 7haY co/�I �/Y �✓ e�'� �'I��ic<�a/pry o� ��!h�a�� 2 n 5u la,rio h a s r���• shy/i Pty � h !� o SPS C- leva�iorls ShoU✓� 4'o/- s>°F�l�`G off' p) Shallow 6& /a c' !moo-tqor;7 tom a� S% P/ah w rf�j OF `a°.qa�t 417e.'y,�P�E,,......•,,,.•s�9�! 7+/j.'� e bql-1c�'2 Y .. { e V !. �/ P. (�j �.(/ �v �u� C�� 7/ �! C��%� ♦ F . James F. Sizemore • �W ,1 �n�•. # 1517 E •?'i :l a Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST SEAL) t 1 v' 7.h'' oc::'.'ce•i'. -41,-rpG(t' PERFORMED FOR: /)SAN 1-�CLI sN IPOt- L: eoZ !( DATE PERFORMEDZ.,,r, z 9 LEGAL DESCRIPTION:_ LOT ST RICI Township, Range, Section: SLfLI TI h1'P-31& 1 t (-INF12—NI114A -rr—QP— SLOPE SITE PLAN _. 1 2- 3 3 4- 5 5 " 1 6 E 9 lO 11 IIWAS GROUND ENCOUNTERED?ATER IF YES, AT WHAT 15, 12 0 DEPTH? Depth to Water Alter 13 Mandating?? sIC i q 14 �15 Ilig— ,1141 3�y7 BvTrowr p F 16 kiOLF- 17 18 19 20 COMMENTS Reading Date Gross Time Net Time Depth to Water Net Drop —O — ".m_ I(s�L r 'JQ _ lh S t 3 ,, 3 a pie PERCOLATION RATE %� )•rt�,nutes/mch) 1C HOLE DIAMAER 3�B / TEST RUN BETWEEN FT AND Ly� _l�— FT PERFORMED BY: 0 - Sjt&e&er14 I CERTIFY THAT�� TEST WAS PERFORMED IN ACCORDANCE WITH ALL STAT AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: !/ 72-0081Rev. U85) I - `(ENGINEER'SSEAL) IF • ar Municipality o1 Anchorage DEPARTMENT OF HEALTH 8 HUMAN SERVICES '^ '. ...... 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED LEGAL DESC 1 2 3 4 5 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS Cie 6✓as4.tA 726AN1 L! GN / q'`' 1� C,7 rat ✓-t-e g PERFORMED BY: ACCORDANCE WITH ALL 72-008 (Rev. 41&5) r a21:3 Ca4i�F,•••� , � z ._, 1'Lf DATE PERFORM6L0 '�x71A$r Township, Range, Section: 71 I N ! P'2' �j SLOPE SITE PLAN WASGROUNDWATER ENCOUNTERED? D] IF VES, AT WHAT ' DEPTH? Depth to Water Aller Monitoring) Date: PERCOLATION RATE tminutewmcn) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT 1 I CERTIFY THAT THIS TEST WAS PERFORMED IN AND MUNICIPAL Gb4Z)ELINES IN EFFECT ON THIS DATE. DATE: a Munklpallty of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED LEGAL DESC 1 2 3 4 5 6 7 8 9 10 11 12 —Z-43 3/.L7 to 15 16 17 18 19 20 COMMENTS Ci4CY—ce.Y✓IA Te.re- ✓.-41�1�C 6 a Cl ra✓tlly S J5o7-7"o 44-1 O F N'0L1= PERFORMED BY: —Q ACCORDANCE WITH ALL STJ AND MUNICIPAL 72-008(Rev. 4/85) WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEPTH? Depth to Water After Monitoring] , •".•1ENGINE 1SEA1.) 'f,C�^, s: viii •^ �n r •• ... .... .. 6• 7 are:•a :^. ik:anl : ;;, it �•. CE 272: _ J _DATE PERFORMED: Section: T I t N4 SITE PL ■■■■■■■■■. ■■■■■■.■■■ .■■■■.■■■■ PERCOLATION RATE (minutesnncrn) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT 1 CERTIFY THAT THIS TEST WAS PERFORMED IN 'SIN EFFECT ON THIS DATE. DATE: u4C Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 14 G -'5. T��i��%l�_Y�� / DATE PERFORME LEGAL �DESCRIPTION: LS E�� r17��c�irl,Ato Township, Range, Section: IJ Al SLOPE SITE 1 2 G D 3 G G Al 4- 5- 5 6 �r��m©osteo 0 7 8 9 10 off. o!e 12- 13- 14- 15- 16- 17- 18- 191 213141516171819 20 COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Dale. W ®=mmm �r��m©osteo PERCOLATION RATE R (minutesimCh)�PERC HOLE DIAMETER TEST RUN BETWEEN 4' FTAND"`��—Z FT PERFORMED BY: '" 1 CERTIFY 7T : THt TEST WAS PERFORMED IN ACCORDANCE WIVH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/115) OF AL 7 —ir\QZfJrGI}�EE S! � 47 i y . Municipality of Anchorage i �. r49?��y+•`�' DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502 -OM •���� 9 James F. Sizer SOILS LOG — PERCOLATION TEST �j s1�e_ r 1517 E PERFORMED FOR: lw'-4; nt/ ✓i PfJ i?%F �T�r� � DATE L LEGAL DESCRIPTION: 5 I Gl%I(�G'r'cN/%d I Township, Range, Section: 1 -/r/-L- 2- 3- 4- 5- 6- 7 3 45s7 b 0 s 0 9 9 10 11 (/ S 12 %i 13 14 15 16 17 18 19 20 COMMENTS GM Grover' S�l� PERFORMED BY: ACCORDANCE WITH ALL STATE 72-MBJRe . M85) SLOPE WASGROUNDWATER .! ENCOUNTERED? ✓ S If YES, AT WHAT DEPTH? ,1 Depth b Water Alter iTo`e M°^iturin07 Date: SITE =m l u rd— PERCOLATION RATE i 3 (mt .tes/mctt) PEFiC HOLE DIAMETER � � TEST RUN BETWEEN 4-5 FT AND 5 FT L/ I CERTIfY T/HfT THIS TEST WAS PERFORMED IN MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �` �f JAMES SIZEMORE & ASSOCIATES CIVIL ENGINEERS & SURVEYORS 6410 Switzerland Drive Anchorage, Alaska 99516 (907) 345-1572 27 May, 1991 Septic System, Lot 5, Block 1, Cinnerama Terrace Subdivision The Site Flan Shows the location of the proposed house, well, soils tests and the water level monitoring tube. The 3.1 Acre lot is timbered fairly heavily and slopes Northwesterly from the road before leveling out on the Northern part of the lot. There is a drainage easment down the Eastern lot line. The surface drainage currently is absorbed by the mossy organic ground cover. The lots surrounding this lot are also large, and developement of a home on this lot is compatible with the intended use of this land. The soil logs from the test holes and the percolation test indicate that a shallow trench absorption system can be used. A total trench length of 94 feet is required. Therefore two 5 ft. wide trenches, one 50 ft. and one 45 ft. will be built. The bottom of the trench will be approximately 4 feet. The Septic tanl: will be a two compartment, 1000 Gallon Tank. All piping and drain tile will conform to Municipal Codes. Jammeys� F. Sizemore F.E. OF A *-I 9TN y� • James F. Sizemore # 1517 E a (D 0 z 0 Z LU � � \ �/ 3 C 3 cot I 88 \ \ / LL: LL! LL! / L6 L, L6 L6 coo �6(:5cic;C5 Ul" 1; w L6 F4 L6 0 00 0 0 0 0 w w 0 k/ ce ce w w w � � � � k . 1!77 %,Lie \ \ \ L6* L6, L6 L6 w w \ \ \ ell bc5ci k§§ k§§ \ \ \ LL: L6 L6 \ \ \ � \ 0 0 0 cc: C4 = = C4 ce cl: w cc: L6 L6 L, L6 W L6 L6 L6 L6 L6 L6 L6 LU OE �/ 3 C 3 cot I 88 \ \ / LL: LL! LL! / L6 L, L6 L6 coo �6(:5cic;C5 Ul" 1; w L6 F4 L6 0 00 0 0 0 0 w w 0 k/ ce ce w w w � � � � k . 1!77 %,Lie \ \ \ L6* L6, L6 L6 w w \ \ \ ell bc5ci k§§ k§§ \ \ \ LL: L6 L6 \ \ \ � \ 0 0 0 cc: C4 = = C4 ce cl: w cc: L6 L6 L, L6 W L6 L6 L6 L6 L6 L6 L6 ;IY•j111114 A 10 Municipality of Anchorage "' s On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date;_ r l f I Complete legal description Cinerama Terrace, Block 1, Lot 5 Location (site address) 8705 Cinerama Circle Anchorage, AK 99516 Current Property owner(s) Kent & Sarah Freeman Day phone Mailing address 8705 Cinerama Circle Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: I] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual E Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Publi, W'ter Syste ❑ Public Sewer ❑ WaiverNariance request for: Distance: 7 Received by: y 1 _> Date: I { " COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment�b�� r Date of Payment Receipt Number �g Vj Receipt Number COSA# C)c5e i3 �1� 1 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 Anderson Engineering Phone 522=7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD Sl NATURE ldd System #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms Date 10/26/2013 bedrooms, with the following sti ;4iH'E:C 4DEP.SON -" CE -4381 PROfESS10 By;Original Certificate Date: y 13 Th ni i f orage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the repr sentations 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 engineers work. ATTACHMENTS. COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet f 1.: 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: Cinerama Terrace, Block 1, Lot 5 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 8/31/91 Sanitary seal (Y/N) Y Total depth 225 ft. Cased to 27.5 ft. FROM WELL LOG Date of test 8/31/91 Static water level Well production WATER SAMPLE RESULTS 50 ft 2 9 - p.m - Parcel ID: 020-521-04 Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 10/11/13 65.4 ft 4.95 g.p.m. Coliform 0 colonies/100 mL Nitrate '104 mg/L Arsenic N/D ug/L Date of sample: 10/11/13 collected by: Anderson Engrg. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal Number of Compartments 2 Date installed 6/22/06 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) N Date of pumping Q' 0c i.3 Pumper C. ABSORPTION FIELD DATA Date installed 6/19-22/06 Soil ratingz z .8 GPD/SF 5' Wide Trench (g.p.d./ft orft /bdrm) System type Length 132 ft. Width 5 ft. Gravel below pipe 1 ft. Total depth 5-6 ft. Eff. absorption area 759 ftp Monitoring tube Y Depression over field N Date of adequacy test 10/11 /13 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0/0 in. Water added 668 gal. New depth 1/0 in. Elapsed Time: 1,440 min. Final fluid depth 0/0 in. Absorption rate >= 600 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date 11111I3I&A FT -1111 111191k,I Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot > 100' On adjacent lots > 100' Absorption field on lot > 100' On adjacent lots > 100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line >25 Holding tank N/A Animal containment areas >50 Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation > Property line >5 Water main >10 Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: 1'*** Property line Building foundation >10' Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS ***Lot Line Waiver Issued. G. ENGINEER'S CERTIFICATION 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 Michael E. Anderson, P.E. Date 10/26/2013 COSA brown sheet 10-10-12.doc Absorption field >5' Surface water >100' Water main N/A Driveway, parking/vehiclestorage >10, AEL E ANDERSON o CE -4381 e� tliw Municipality of Anchorage •aaa sy - Development Services Department ; Building Safety Division _ Onsite Water and 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 Parcel I.D. 020-521-04 COSA # 0 '�__ 0 6 q Expiration Date: / D - 1. GENERAL INFORMATION Complete legal description Lot 5, Block 1, Cinerama Terrace Subdivsion Location (site address) 8705 Cinerama Circle Current Property owner(s) Jim Dyer Day phone 223-6989 Mailing address P.O. Box 231029 Anchorage, AK 99523 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: Four (4) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well❑ Individual On-site ❑� Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 OnSfte Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-sfte 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 properties 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 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, 1 verify that my investigation, based on procedures outlined in the Certificate of Onsite 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Phone 522-7773 Engineer's Printed Name Michael E. Anderson, P.E. Date 7grz006 4`1 49th 6. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory VIY'JI I C WATCD Aiir1 WAS I tWAI LK Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: .ta/— �� Original Certificate Date: :Z (Rw.IIM) 11 Municipality of Anchorage' •., • Development Services Department Building Safety Division . On -She Water a Wastawater Program • , ' 4700 Bragew street P.O. Box 196650 Anchorage, AK 99519-6650 www.munLorg/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Descriptio,: Lot 5, Block 1, Cinerems Terrace Suedlvsion Pareal lD: 020-21.04 A. WELL DATA Welt type PAvate If A, B, or C provide PWSID S _ Wed Log (YIN) Y Date completed 821/91 Sanitary seal (Y" y Wires property protected (Y/N) Y Total depth 225 ft. Cased to 27.5 ft. Casing height (aboveground) 24 in. FROM WELL LOG AT INSPECTION Date of test 8131/91 11/10/05 Static water level 50 R Well production 20 9 -p.m - WATER SAMPLE RESULTS: Coliform —1--colonies/1 00 mL Nitrate .1 mg/L Arsenic: NIR mgA Date of sample 11M0/05 B. SEPTIC/HOLDING TANK DATA Tank TypelMatmiel SOPOCISteel Tank size 1,250_ gal. Number of Compartments 2 Foundatlon cleanout (YIN) Y Depression over tank (Y" N Date of pumping New Consarrcdon Pumper C. ABSORPTION FIELD DATA 78.6 R 2.1 g.p.m. Other bacteria 0 colonies/1 00 mL Collected by: LH. Clesnouts (Y/N) Y High water alarm (YAC N Date installed 6119.22/Z08 Soil rating (g.p.d.fie or te1bdrm) •8 GPD/SF System type 8 Wide Trench Length 132 R Width 5 R. Gravel below pipe 1 fL Total depth 5$ fL Eftabsorption area 759 ft' Monitoring tube Y Depression over field N Date of adequacy teat New C0nsL Results (Pass/Fain 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.) (YM & type) if yes, give data 0. UFT STATION Date instafiv Size in gallons Manhole/Access (Yllh 'Pump one level at _ in. 'Pump or level at _ in. High water alarm level at in. Datum Cydes tested Mw b alarm a dreuit remdrerwls? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanm station on lot >100' On adjacent kits >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main WA Public sewer manhole/cleanout WA Sewar hreptic service one >25' Holding tank WA Animal containment areas None Manurelardmal excrete storage areas None SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Bu0ding foundation >5 Property one>6 Absorption fiekt �5 Water main WA Water seMce line >10' Surface water >100' Wells on adjacent k1b >1W SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TQ Property one 1"" Building foundation >10' Water main WA Water Service one >10' Surface water >,Iw Driveway. PerkingeNde storage >25' Curtain drain None Noted Wella on adjacent kms >100' F. COMMENTS: "'See Lot Line Walow. COSA Replaces Conditional CertlNeate Issued December B. 20013. G. ENGINEER'S CERTIFICATION I cerMY that I have determined though field kgxctlons and review of UU1** ori records that the above systems are in can brmance wifh MOA COSH guidelines In effect on this date 0 Engineer's Printed Name Midwel E Anderson. P.E. e Date W tAM COSA Fee $ Waiver Fee $ 1.!� Date of Payment /S Date of Payment M&k9k Receipt Number Receipt Number ��� ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 -7773 677-7766 (F July 7, 2006 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 5, Block 1, Cinerama Terrace Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: Very little area exists on this lot for the replacement absorption system site. Rather than demolish the existing system and rebuild in the same location we moved the absorption trenches to within 1' of the western lot line to achieve proper separation from the existing well on the lot and surface water in the area. Placing the absorption trenches at this location will have no impact on the system or well on the adjacent lot. The existing absorption system will remain in tact and may be used in the future should the need arise. All separation distances can be met from wells, surface water and septic systems in the area. We therefore recommend the lot line waiver be issued. Sincerely, Michael E. Anderson, P.E. l�Zuiucipality of Anchorage C0. Na 1!*X;R)-.finch"nige. Masl{n!M 751!) -Na) • Tdcphnuc (!M)7):R MM • Fax (107) UM- M) C- 471X1 ISnrpanc tiircct •.lnehnmgc, Alaska !klilli Nl\wi nnll.nrg Ifayor 1/ark I3cgicl) Ilttilding Safcty Dh9slon 7/10/2006 Anderson Engineering P.O. Box 240773 Anchorage, Ak 99524 Subject: Waiver Request for Cinerama Terrace Block 1 Lot 5 Waiver Request #WR060029 Parcel ID #020-521-04 HAA#050628 Permit # 050447 Dear Engineer, Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 1.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poct Engineering Technician On -Site Water & Wastewater Program Community, Security, Prosperity 5• Municipality of Anchorage Development Services Department a "' Building Safety Division On-SitcWatcr and Wastcwatcr Program f 4700 Bragaw Street P.O. Box 196650 Anchoragc, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 WR#: 060029 PID#: 020-521-04 Dale Received: 7!6!06 Applicant: Jim Dyer Waiver Review Worksheet HAM 050628 Permit#: 050447 Waiver Requested: 1 foot separation distance absorption field to Property line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ...•.......•............•...................................................... Waiver Is Granted: 1-1� Waiver is not Granted., Ust Conditions or Reasons for above: Date: — – d % By YVa::!:T -Ja�it eo(Reviewer ............................................................................... Rec#: 7.6-06 Amount: $175.00 Date Paid: 7-6-06 83-547 CINERAMA TERRACE SUBDIVISION LOT 5Y7 �B LOCK 1 l. VVII.LV II 19V Lf L - I/ \IV • / SCALE: 1 "-20' C\NERpMA C\RC� GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 4726 WEST 88TH AVENUE ANCHORAGE, ALASKA 99502 PHONE 248-5454 GRID DATE 3241/3341 7/5/2006 F.B. JOB NO. 06-08 CTS51 I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. R IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE .� p�•<<','' OF A4 ♦j AV co ' ''• .v �..:..giff .......... ": i e: Y 0. Gd/told) . c AV ♦o.; ��u ♦ °r •. LS -6091 1AV ••x3 411\s\�\•• =60' Lit 090towt(n, Municipality of Anchorage Development Services Department �• Building Safety Division On -Site Water and Wastewater Program , 4700 South Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 • www.cl.anchorage.ak.us Fj 1I (907) 343-7904 �+� CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 1-04 HAA# hF;C(0QR Expiration Date: — - 06' 1. GENERAL INFORMATION Complete legal description Jot 5, Block 1. Cinerama Terrace Subdivision Location (site address or directions) _8705 Clnerama Circle Current Property owner(s) _Jim Dyer Day phone 223-6389 Mailing address 8705 Cinerama Circle Anchorage, AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, NAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Three 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site El Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an Independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 sample results less than 30 days old. (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 Health Authority 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 Anderson Enaineerina Phone 522.7773 Address _ P.O. Box 240773 Anchoraae. AK 99524 Engineer's Printed Name _Michael E. Anderson, P.E. Date 11/18/2005 49th E. amrnsw 5. DSD SIGNATURE Approved for bedrooms. Disapproved. X Conditional approval for 3 bedrooms, with the following stipulations: $15,092.50 to be escrowed for work pursant to permit 4050447. Work to be completed by 15 Jun 06, by a certified installer. Additional Comments Attachments: HAA Checklist Septic'System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other By: IQ o .-.Z It/ 2a-e_� Original Certificate Date: rnw. twos Municipality of Anchorage Development Services Department Building Safety Division On-site Water 6 Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 995198650 www.cianchorage.ek.us (907) 343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 6, Block 1. Ctnersma Tenaca SMMSIon Parcel ID: 02b16M!_ 6_ ,15".71 - o 14 A. WELL DATA Wen hype Bko If A. B. or C provide PWSID # WOO Log (YIN) Y Date completed 8131($ 1 Sanitary seal (YIN) Y Wires properly protected (YIN) Y Total depth .an_fL Cased to _U _ft Casing height (above ground) __U _in. FROM WELL LOO AT INSPECTION Date of test 6131M991 111`10I2005 Static water level 50 ft. 78.6 ft Well production 2.0 g,p.m. 21 g.p.m. WATER SAMPLE RESULTS: Coliform -L-colonies/100 ml. Nitrate -A- mg.A. Other bacteria _L cokmiW100 ml. Date of sample: 11M Z0S Cclleated by: LH B. SEPTICIHOLDINO TANK DATA Tank TypalMatedel _8Md8teei Data installed 10M2M991 Tank size Igo gal, Number of Compartments j Cbanouta (YM) Y Foundation deanout (YIN) Y Depression over tank (YAV) !I High water alarm (YIN) N Date of pumping 10I4I2001Pumper _Noses C. ABSORPTION FIELD DATA Date installed 6G10120pti Soil ruling (g.p.d.Als or tt lbdrm) A oppr3F System type _IV Wide Trench Length 100 it Width 5 R Gravel below pipe 1 it. Total depth I fL Elf. absorption area Ma Monitoring tube i Depression over field N Date of adequacy test Results (PasslFaip For _ bedrooms Fluid depth In absorption field before test _ in. Water added_ gal. New depth,_ M. Elapsed Time: _ min. Final fluid depth _ in. Absorption rats >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date Installed 'Pump on' level at _ in. Datum Size In gallons 'Pump otr level at _ In. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankilift stallon on lot 3100' Absorption field on lot 3100' Public sewer main NIA Sewer /septic service fine _ >2T Manhole/Aocess (YIN) High water alarm level at Morrie alarm & dreu t rewhamems? On adjacent lots M00' On adjacent lots 3_100' Public sewer manhole/cleanout WA Holding tank _ WA SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation >T Property line >' Absorption field W Water main WA Water service line _>f0' Surface water MW Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property fine Mir Building foundation >f0' Water main >10' Water Service Una 310' Surface water MW Driveway, pwkiroVehide storage >2T Curtain drain Nona Noted Wells on adjacent lots 3100' F. COMMENTS O. ENGINEER'S I certify that I have determined through Beld inspections and ° 49th review of Munk 4W records that the above systems are in conformance with MOA HAA guidelines in efed on this date. rarJNR 4 NQ<RS Engineer's Printed Name _ Michael E Anderson, P.E. 4 No. CE -4M Date 121812005 ♦441�pep HAAFee $ 4Y 1. t d/lf iw, ►•tPy�Jw t Date of Payment 14 -4 -OT Receipt Number (Rev. 12MM Date of Payment Receipt Number in. i 17 8z31'p' . , ./8 Rae I :. . , {. ;.... ...i. .... i .. t J ' 4• • 1�. ; �.r• ; .. .. ! :.... .... .. ��.n ."fes. V .�� i � • . i �`. VIS w S. 1 � , i i... _._.. - .. s. \ . • ... ... f i i { � 1 , ; ,�..: ,..y,.:: I a<;_... * � -Yom•.-! -I.,. r�BJv r r��� .... _ ' ! :, ' ..... �1�• l ? rel tO>5 . ro' t a �$�� -{sere .i : ;CAP ::..e{...�. _ l .. ... . ! �FQb a � 1.1iT' iS.T'gKic.D: � f�� 'Z5'4!a' 1 { . .r . l 1 , ',.rY � .•1 ( { 1 1 .. .... { ..... .._ .. / 1 • : i ' ( • ,-t_ ( .� � 1 .' `?i : � ' i Ir.1 ! . , . •itl�11� i 1 . ' 1•'..f_ �"' '+ ,-.; fir'. 1 ,.-.. •"_.» '.� . . 1 .... .11. _... . . , . . . • _ r : • ! . I , - • 1-i._.. rt.. F a-1 • i'r f 1 Y r • 1 ., .. . .,_, . . ... - . 6 I( f 6lVI T -NII EMME 6�ETTH1 A H `'.; ..; J .: ::�:i ,::.ry - f - ::(' :i ;_ _ . f — I. : :Ot tne• 104v lowin dB Crrtbed proptrfy! F 1 '. 1..1 + ` �.• .} ar•.. ��. +!. 1 = .• ; 1 . .I ,.,. i ! f ..E1:. iy 1 + + -: ::: . . .:. .. .. . . :. _ ...... :—Ancfio`r a Re i Io r nct... a� +an ai 7i �Inee it do not thereto, nts"iltuated ih rlon a wnhlrt�h to •.... {. overlap or .error h o1 61 pro ry, .�y ng�iadjace h(at Improvem i n �dJacpnt tf?ere b ± r��� a � f ! " --- ------- -- ::enbrio8 roadwa _ prove paled a no It on;ptoplR onahe prem( s.(1� !gtesnonlart (e. s(tfansmlgs!ort if as bRdtt�e VlItiI 6aserr a tepn pw :>' Wdlca • 1 . An.-hota Ales e.r .. -' y. {...-{_......... .� .� 1 t ..�1 • iS.'•^ J.1 1 •, rri I 1 { j .i ; ; � : i + 1.1 ♦.; �-h.t.l Y. I , j { r -.i : ;. • ......:..... i I .. ... ' I , this' .....: _ D BFQ-:-.- 11 dab 20 +' '.'EASEM 8E F (907) 2 .:FRED �blA 7 i&'. �n f T"' 8,1888 i. .. !Englneelj6lan dn!eY?r4: i }- i r t Y ; pWN { r TH08E 8H : i 1. +-P� TAI F ttl RECORD; I THH R6CORp T 6HQirYH. R8yyy0t�.. .. ; ( • ; j.:...:.a •I,F6Y1.1%S.I *::..J!-1 `t 7.j r%.7 TT:.! .�,?::; ' i - . • • 1 1 • ,.• • • • • 1 _.•..1-r...1 L• .1.:,.1.3-{_I..:l I".-1 ..T 1.3�1:.r.i 1 .•, IJ.I_I 1 ..1 • • 1I.IJ 1.1.•.�.I.l.l_I..I.A. I;, • I • 1 ( • • , ,Dgme•!4.Zri3 1 Municipality of Anchorage • Development Services Department Building Safety Division Onsite Water 3 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.sk.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-033-08 HAA# HA o l O 5" 7 0 1. GENERAL INFORMATION Expiration Date: i - 'p- 9 - D2, Complete legal description CINERAMA TERRACE SUBDMSION: LOT 5. BLOCK 1 Location (site address or directions) 8705 CINERAMA CIRCLE ► ANCHORAGE, AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address SANDY POMEROY Day phone 345-9570 P.O. BOX 112564 • ANCHORAGE. AK 99511 Day phone KATHI CHAMBERS w/ REMAX PROPERTIES Day phone 727-5500 2600 CORDOVA STREET * ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 sample results less than 30 days old. (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 afted hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Health AuthorityApproval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system Is(am) 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 Finn ALASKA WATER do WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SURE 26 * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AWWC, Ina attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines d Regu/Mons. The reported results described the performance of the system under the conditions encountered at the time of the tes4 and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local sops 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 am no hidden defects or encroachments. AWWC, Ina 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 R confer any legal right whatsoever. 5. DSD SIGNATURE 337-6179 Date 26 I, Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the tllowing stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineers Reort Other �gYIOE ON-SITE •'e SAND • r WASTEWATER �M 11 By: 1"1-/ &/ �O Original Certificate Date: M". 12M) Municipality of Anchorage Development Services Department 0"lte Water& WastowaterProgram 4700 South Srapaw SL P.O. Bax 108850 ArWarape, AK 995194850 WWW.d.ancho PAk.os (907)943-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Desorlpdom CINERAMA TERRACE SUBDIVISION: LAT 5. BLOCK 1 Parcel 10: 020-033-08 A. WELL DATA Uq-M3,jfell *4PIOOt II Wen type ORNATE H A. B. or C provide PWSID# N/A Date completed 8/31191 Sanitary seal (YM) YES Total depth 225 fL Cased to •27.5 fL FROM WELL LOCI Date of teffi 8/31/91 Static water level 50 R Well production 2.0 g.p.m. WATER SAMPLERESULTS: Well Log (YM) YES Wires properly Protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 8/7/2001 87 fL 4.5+ g.p.m. Conform _0 colonleW100 ml. Nitrate 0.5 nVA. Other bacteria O colonlea/100 ml. Date of sample: 10/18/2001 Collected by: AWWC. INC. 8. SEPTIC/HOLDING TANK DATA TankType/Materlet STEEL Data Installed 10/12-19/91 Tank size 1000 gal. Number of Comparinrente 2 Cleanout (YIN) YES Foundation cleanout (YM) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Data of pumping 8/7/2001 Pumper ISAAC'S PUMING SERVICE C. ABSORPTION FIELD DATA Date instened 10/12/91 Soil ratirtp .pA ferodnn) O_8 System type TRENCH Lenplt► 101 ft Width 5 fL caravel below pipe 1.0 R TOW depth 4 +/— Eff. aDsorpUon area 580 fe MMRDrb g tube YES Depression over fletd NO Date of adequacy lest 8/7/2001 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption field before test 1.25 in. Water added 814 gel. New depth1.251n. Elapsed Time: 0 min. Final fluid depth 1.25 In, Absorption rete r. 450+ g,p d, Any re)avenatlon treatment (past 12 mo.) (YIN & type) NONE KNOWN If yea, give date — D. LIFT STATION Data installed 'Pump an' level at ---In. E. SEPARATION DISTANCES Size in Cellons High water alarm level at ht Cycles tasted Meets alarm & dreuft requirements?— SEPARATION equirements SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanMM station on lot 1001+ Absorption field on tot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots too'+ On adjacent bts 100'+ Public aewermanhdeldeanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDINO TANK ON LOT TO: Building fouMlAtion 50+ Property 9ne 5'+ Absorption field 59+ Water main N/A Water service tine 10'+ Surface water—t-1 —OV+ Welts on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property Kne • 10'+ Building foundation 10'+ Water main N/A Water service ane 10'+ Surface water 00100'+ Odvewey, parkbV"htde storage 50'+ Curtain drain NONE KNOWN Wells on adjacent bffi 100'+ F. COMMENTS *SEE ATTACHED SURVEY **SEE ATTACHED LETTER 0. ENGINEER'S CERTIFICATION I cot* that I have determined dumgh fled hrspecilons and reHewofMunkWfricords that ft above systems ant 10 cm tbrmwm wlM MOA NAA gu/dellnes In effect on Bds date. Engineer's PdnW JEFFREY A. GARNESS Date TO`Lll HAA Fee S 30n -'o Date of Payment /0 - a Recelpt Number 01/9C05 FW. 121007 Waiver Fee $ Date of Payment Receipt Number A. GCr -7953 ALASKA WATER & WASTEWATER CONSULTANTS, INC. June 12,2001 Sandy Pomeroy P.O. Box 112564 Anchorage, Alaska 99511 Subject: IIAA for Private Well R Septic System. Lot 5, Bk 1, Cinerama Terrace S/D. Mrs: Pomeroy: The subject lot has a 3 bedroom house on it which is served by The results of the field investigation and adequacy tests are sum A. WELL: The static water level on 6/7/2001 was 67' below, pumped from the well at a rate of 5.8 gpm for a total of 105 mini the pumping period, the water level was still dropping slightly cycle which indicates that the well was continuously producing with the pump. Based upon this data, it was determined that the Municipal requirements for a 3 bedroom house (.31 gallons per 9 well and septic system. as follows: e top of the casing. Water was les (614 gallons). At the end of in the casing but had begun to a sufficient amount to keep up :anacity of the well exceeds the B. SEPTIC SYSTEM ADEQUACY TEST: The drainfield onsists of three (3) five foot wide trenches which are 45 feet long, 41.5 feet long, and 14.5 P& long with an effective depth of 1 foot. Prior to starting the adequacy test on the second ch, the M.T. had 1.25 inches of liquid in it. After adding 614 gallons of water to the , the liquid level had not changed. Based upon this data, it was determined that the absorption rate of the trench exceeds 450 gallons per day, as required for a 3 bedroom house. C: SEPTIC SYSTEM IS TOO CLOSE TO SURFACE WATERS: The existing house sits on a pad which is elevated above much of the surrounding land. There is a cutbank just north of the smaller trench, beyond which is a swampy area with ponded surface water within 20 feet of the drainfield. The cutbank curves around the lot on the east where there is more surface water concerns within 73 feet of the tank. The municipal code requires a separation distance of 100 feet or greater between septic systems and any surface water. The M.O.A. will not grant health authority approval until these separation distance encroachments have been remedied. There is a possibility that the municipality would grant a separation distance waiver for surface water encroachments. There is a $920.00 M.O.A. processing fee for such a waiver as well as an additional $500.00 to $600.00 in engineering charges involved in this process. It is likely that after processing the waiver package the municipality would not grant a waiver for such a close separation distance (20 feet). It is our recommendation that a reputable excavator be hired to 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com bring in fill to eliminate all surfacing water within 100 feet of the septic system. We suggest that you contact A+ Home Services at 345-1890 or Dan Beek at 242-9650. Have them call us with any questions pertaining to the scope of work. If you have any questions, please contact us at 337-6179. .E., M.S. �p�2S/DI Ste( W (Z F, •,�- lv�,--�-PJL I SSv�3 p nr �w.7-14. U,.r Srr� � o OiSG...�s cQ�rz2�-,ice A-Wk/G, floc wE�2E (5' n p fYJln") CMa-. pon�J��1� 6901 Debarr Road, Suite 2-11 * Anchorage, Alaska 99504 Ph: (907) 337-6179' Fax: (907) 338-3246 * Website: akwwc.com Z 'd 0196 'ON S31J,x3d03d XYW33 wddti:d IOOd 'SZ '130 9