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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:
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1 5
Cinerama Terrace
2 Ft.
1 FL
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2.3 Ft.
132 FL
Well: Existing
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759 Fe
ASTM 3034 PVC
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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.
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>5'
>10,
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ti
in
h
None
Noted
PGTA= Mad./
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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
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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
\
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DISH \
rE \
\
if FENCE (AP%)\`
_ C�t'El DRNE * J
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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
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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
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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
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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.
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l
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i
a 1474 `,i cf?;cf ZJ15u/
err
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r 06.
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f E-1 14 2 i *'49L a..
Vie{ MN•N•N ,w •Wry
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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
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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
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SY S�-C!�?S J�/fc10;!^ l9q ve.-,Sic�iJ
"he, Shc7/lore tr'e�Gh�s ssem;// 6�
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-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�
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— 3yS-9719
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NI.NI•IIN�.1 •.N.N�..
James F. Vzomore
•. # 1517 E
40
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7"��'race su6div�5�o�
P��'� ��`�� = e� �r:•�/ire.
� �� a S ha6lo cv T�'�
1 ile
FO- r 5 O' P, ffo(�se ,
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-FIT
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.9TH
James F. Sizemore
• y 1317 E �•� �V�.i
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G
S%/ S -lcm
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-/- e s '9,
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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
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leva�iorls ShoU✓� 4'o/- s>°F�l�`G
off'
p) Shallow 6& /a c'
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tom a� S% P/ah w rf�j OF `a°.qa�t
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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.
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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.
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6901 Debarr Road, Suite 2-11 * Anchorage, Alaska 99504
Ph: (907) 337-6179' Fax: (907) 338-3246 * Website: akwwc.com
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