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Home My WebLink AboutCINERAMA TERRACE BLK 2 LT 3 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: ~c~ (3 ~(,p~ PIDNumber: O7-,(~ - ~ Name: ~O~ ~, ~, ~c~n~. ~.~c~l~ WastewaterSystem: ~New ~Upgrade Address: ~ ~o~ S~, ~ h~ ~o~ ABSORPTION FIELD Phone: ] No. of ~e~rooms:~ ~Deep Trench D Shallow Trench O Bed ~ Mound ~ Other LEGAL DESCRIPTI ON so,, Rating: 0, ~ GPD/Sq. Ft. Total Depth from original grade: Lot: ~ Block:~ ~~Subdiv~i°n:~~ Depth to pipe boffom from origin~g, rade:. Ft. Gravel depth beneath pipe ~ Ft. Township: I,.n~e= Is.~t,o., Fill added above original grade' Gravel length: 0 .,. Ft. Ft. Number of lines: Distance between lines: WELL: ~ New D Upgrade Gravel width: ~ Ft. ~ N ~ ~ ~ Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Date Drilled: Static Water Level: Installer: ~ Date installed: I Pump Set at: ~ Casing Height Above Ground: Yield: ~ GPM ~5 ~. I / '~ + ~'. TANK SEPARATION DISTANCES ~s~ptic ~ Ho[di,g ~ S.T.E.P. TO Septic Absorption Lift Holding =ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~C~O r ~~ ~ Welb i ~ 0/~ } 00 / ff. ~ ~ ~/~ Material: ~~ Number of Compa~ments: Sudace -- ~~ LIFT STATION Water )0~ I00/~ ~ -- Lot Size in gallons: ~ Man~: Fou.dation ~ ) I ~ ~ / ~ ~ . "Pump on" level at: I "Pump o." level at: ..... ~h water alarm at: I Cu~ain ~0 ~ ~ ~ g .... ~ Pump Make& Model Electrical Inspections pedormed by: .... Drain Remarks: BENCH MARK Location and Description: Assumed Elevation: O .... ....... Inspections pedormed b~:& 5 EN~Im~~ii~G Dates: 1st Z- ~ -~ ~ ~..~~ i 7034 Eagle Eiver Loop Road, No. 2~ 2nd ~ - { 0 - ~ [ ~ ~ ~ EOBEET C. COWAN Depa ment of memtn anaHuman Se ices approval ..... '~tL Reviewed and approved by: ~~ ~~ Date: ~'~/- ~ ~ 72-013 (Rev. 9/91) MOA 25 PERMIT NO SW980265 PAGE 2 OF 2 DEPARTHENT OF HEALTHAND HUP AN SERVICES ENVORONHENTAL SERVICES DOVISION , P,O, Box 196650 ~nchorage, Alaska 99519-6650·Telephone, 343-4744 ON-S~TE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 3, BLOCK 2, CINERAMA TERRACE S/D P.I.D. NO. 020--033--12 ST1 ,_98.0fl' NEW 1000 GAL SEPTIC BB.1' TANK ,2/F~.AL o~D~k MT2 C02 __COl/MT1 = 90.5' __ ~~-~CO1 = ~ 87,9' ~C02 MTI = B0.3'~ MT2 = 80.5' NO WATER FOUND PROFILE ,~.~' ~.o.,~ 86.4' 88.8' -i-2..L--L- -2 ---- _-_E~ TH · 2 MT2 I¢'"'-- MT1 C02 TBM DBL1 DBL2 (FLOW SPLITTER) A, 8 , C fCO 45.0, 1.3.5 - ST1 52.0 21.0' - ST2 56.0' 25.0' - IDBLll 58.0' I 27.5' - DBL2 59.0' I 28.5' - FS 68.5' 39.5' - C01 - 29.0' 52.5' MT1[ - I 29.0' 55.0' C02 70.0' 66.0' - MT2 70,5' 63,0' - -- 1000 GAL, SEPTIC TANK A SCALE: 1" = 40' ROBERT C. COWAN CF.. - 8801 09:$2 FROM HORELRND & fiSSOC.$73_1013 TO 19076941211 P.02 SIX INCH WATER WELl. DRIL.L£D OUT TO THE: DE:PTH OF ..... IDRILL~D AT THO RATE: OF PER FOOT. - " ~'"" " ' ..... "~ Mr, PROPERTY OWNER ' LOCATION OF WELL SITE ~ernio.. Cl,'..:us of ~..-mr.-?rt Dr~n~. __~.. ~ :':nrk.,. .. ~, DRILLER WELL LOG: WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF~,ff ~ t p 50,., _' PO._. THANK YOU VERY MUCH. TOTRL P.e2 ROBERT C' COWAN, RE. ROBERT A. SHAFER, RE. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED AU(; 1 7 1998 i~lutuc~pahty ot Anchorage Uept, Health & Human Services The septic insDections for the~eferenced property were performed on ~[~/~ ~ and ~//o/q] . Prior to submitting the On-site Wastewater Disposal System and/o~Well Inspection Report we are waiting for the ~u~fz,~/&~8~rIu~/to be completed. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP . SUITE 204 . EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HED~LTH ~ HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, 15J~ASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NLrMBER:SW980265 DESIGN ENGINEER:CONSTRUCTING ENGINEERS, INC. OWNER NAME:WOLF E.SCHMIDT & BRENDA M OWNER ADDRESS:3800 ROBIN ST. ANCHORAGE ALASKA 99504 PAGE 1 OF 1 DATE ISSUED: 7/28/98 EXPIRATION DATE: 7/28/99 PARCEL ID:02003312 LEGAL DESCRIPTION: CINERAMA TERRACE BLK 2 LT 3 LOT SIZE: 70189 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE bEtrNICIPAL CODE CHAPTERS 15.55 AND 15.65 ~ THE STATE OF AJ~ASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AigD DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AlVD CLOSED ON THE SD/V/E DAY B. COVERED, SEALED ~ HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: 27,300 SF MENT TRENCH PERK iST HOLE LOCATION ~TIr ,EPTIC P~ SEPTIC ~OOM WEL WELLI $1TB PL~ PROPOSED WASTEWATER ABSORPTION LOT 3 BLOCK B CI~B~ ~RBACE SUBD~SIO~ PREPARED FOR: D~ ~MITH ~D BRE~A RI$CH P,O, BOX 060 B~RO~, A~S~ ~ I' = lO0' CO~STRU~ON ENOINEERS ~46-~000 O~01 BUDDY ]{ERNER DR 882-88~2 DMAWN BY HAR ~,-2-95 ,~BBOla~'TIO:N' &REA SOl~ RATING, ~P~.e S~M, 0.6 USE ~'W X 6G'L X 6' D = 76B SF MINIM~ FOR TRENCH DB~: aO~ I lO' IIL~ ~PAOT O~ *9~AOZ~ ~TS~ THE~ ARB NO re, yArC WITHIN ~00' ~ THIS A~WTI~ S~TEN. THE I)EglGN DETAILS PROPOSED ~ASTEWATEB ABSOI{PTION SY$TEM LOT 8 BLOCK ~ CINE~A TER~CE SUBDI~SION PEEPED FOEI DAN S~TH BS~-SBX~ P.O. BOX 650 BARR0~, ~ 997~3-6050 CONB~U~[ON ENGINEERS 846-~000 ~801 BUDDY ~RNER DR ANCHOBAGE, .~, ~ 9~ 18 ORAWN BY MA~ 4-2-e6 LEGAL DESCRIPTION: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST C I f~J ~:;/~1' ~44 ~Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SLOPE N (3 WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth lO Monitoring? , Dale:, Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE Z ~ (minutes/inch) PERC HOLE DIAMETER TEST RUNBETWEEN~ FTAND 5 ~' FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: 72-008 (Rev. 4185) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 3, Block 2, Cinerema Terrace S/D Location (site address or directions) NHN Cinerama Circle Property owner Mailing address Wolf E. & Brenda M. Schmidt Day phone 3800 Robin Street, Anchorage, AK 99504 232-8377 Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well xx× Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. XXX 72-025 (Rev. 1/91) Front MOA #21 o 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S & S ENGINEERING Phone Name of Firm 17034 Eagle River Loop Ro~cZ No. 204 Eagle River, Alaska 99577 Address __7, ~/~,,,.~...~ ~ Engineer's signature Approved for T/7/ E _.bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 'q~e :ipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority ,pp~ ':ertificates based only upon the representations given in paragraph 5 above by an independent .~rofes~u~ ~al engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineeCs work. 72-025 (Rev. 1/91) Back MOA ~1 RECEIVED MAY Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES NtUNIClP^MT¥ Environmental Services Division ENWKON~rN. 825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) 343-4744 Legal Description: ~-o 3- ~ Health Authority Approval Checklist 8~,~c.~. ~ C~ ~,,~,4.~a '/'~-~/[A~cel I.D.. 0~-o -03,3 --I ~ A. WELL DATA Well type P A ~ v,,~ ~E_ Log present(~/N) ¥~$ Total depth '~ ~ &~ Sanitary seal (~t/N) 'Y ~ $ If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~ / 3, ~ / ~1 ~' ! Cased to ~ O ~-o uamng height (above ground) Wires properly protected (~/N) Date o! test Static water level Well production FROM WELL LOG AT INSPECTION · g.p.m. / g.p.m. WATER SAMPLE RESULTS: Coliform O Nitrate Date of sam pie: ~ / (0 / ~t o) B. SEPTIC/HOLDING TANK DATA Date installed /0/~-o / ~/~' Tanksize /Do 0 Collected by: Other bacteria $ & S ENGINEERING 17034 Eagle" River LQop l~oad No. 204 Eagle River~ Alaska ~9577 Number of Compartments ~ Cleanouts (~N) C= Foundation cleanout ~/N) Date 6i Pumping/v/4 _ ,v.e.,~ ABSORPTION FIELD DATA' ' Date installed /0~ 3-o ! R ~' Length'~ (~'3 ~ Width Effective absorption area ~'0 q Date of adequacy test/v/,,I. - ,-, ~c ~ Depression (Y~) Pumper - High water alarm (Y/~ ~v a Soil rating ~r fF/bdrm) O. Gravel thickness below pipe System type .'T~.e,,~ c ~/ Total depth /O Monitoring Tube present (~N) ye./' Depression over field (Y/~ ~ o Results (Pass/Fail) For '~ bedrooms Fluid depth in absorption field before test (in.); Im~'. water added (in.): Fluid depth ~ Absorption rate -- .g.p.d. Pe~ast 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT-STATION Date installed Manhole/Access (Y/N) High water alarm level at*_~...~ *Datum Size in gallons ~ "Pump off" level at* E. SEPARATION DISTANCES Absorption field on lot Public sewer main SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / 00 /O0 On adjacent lots On adjacent lots Public sewer manhole/cleanout Sewer/septic service line ~- 5"" ~ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation I '7 Property line -7 o Absorption field Water main/service lin'~/~ ~ +.. Surface water/drainage ! O o + Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: / ! Property line 5' 5" Building foundation ~" {~ Surface water Curtain drain I /oo Y tOO '~ Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots / O 0 F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records SiginC°nf°rmanCee w~th~7~J~' ~'~uidelin~2ct/"~'"~ ' ' ' ~--'- / , on this date. natur ' - '" Engineer's Name Date HAA Fee $ ~ ~ ' ~-~ Waiver Fee $ Date of Payment .~"-/~'~ f~;;; Date of Payment Receipt Number .z~J_~'~.Z/Z ~Z~_.~'~) Receipt Number 72-026 (Rev. 3/96)* ~AY-11-gg 1T:2~ ;ROU-OTE EN¥1RONIvENTAL 5B15~01 T-$?Z P.05/05 F-8~1 CT&E Environmental Services Inc. _ __ _, .......... Laboratory Division - .... - ......................... 200 W Po. er Drwe Drinking Water Analysis Report for Total Coliform Bacteria TeL {go7) 562-23~3 READ INSTRUCTIOn5' O~ ~VE~E SIDE ~EFO~ COLLECTING $~MpZE Fa~. (907} 5B~ -530~ ~ PUBLICWATERS~STEMI.D'~ [ t .1 ~ ! t 1 ~ PRIVATE WATER SYSTEM ~ Unsatisfactory Loop ~o'd ~. 2~ zipco~ SAMPLE DATE' Month SAMPLE TYPE: Routine Repea~ Sample (for romine saml~l~ with lab re£ no. o Special Purpose Day Year SAMPLE LOCATION Treated Water Untreated Water Time Collected Coil.ted By SaWplg over 30 hours old, resuhs may Oe unreliable Sample too long m rransm sample shout4 not be o~gr e8 hours old a, examination m indicate gliaOie resuhs. Please send new s~ple via spem~ d~live~ mail. Tim~ ~i.d _ .. ~E~ Analytical Method: ~"'Ja..._Membrane Ffl~cr '0 MMO-MUG Number of colorlies/100 mi ...... "--* ~ Result* Analyst 881874 BACTERIOLOGICAL WATER ANALYSIS RECORD 5 £. Coil MMO-MUG R~ulI: Total Coliform M~mbrane Filter: Dir~t Count ~ Coloni~lOO mi V~rification: LTB BGB COLIFIRM. Date; 'I'imc ...... Client llotified of unsatisfactory results: Pllofleg ~pok¢ ~itll Fa~d Date: I'ime Coliform/lO0 mi Time ~ ~?~.u~..~ hr~ tl~ll~ Moral:let of [r~e $G8 Group (Sec,ere OenOral~ de Sur~eill~Ince) ENVIRONMENTAl,, FACILITIES IN ALASKA, CALiFORNiA, FLORIDA. ILLINOIS MARYLAND. MICHIGAN. MISSOURi, NEw JERSEY, OHIO. wEST VIRGINIA d· M^Y-11-95 1T:Z$ FROM'CTE ENVIEONMENT^L ~t~__- CT&E Environmen,~, Ser~ice~ Inc. 5615301 T-$72 P.03/05 F-631 CT&£ Ref,# g91974002 Client Name S & S jE[ngineermg Project Name/~ N/A Client Sample ~ ~ 3 Block 2 Cm~r~ Te~. MaTHx Dr~ng Wa~er Order~ By PWS~ 0 Sample R~marks: Client PO~ Printed ~te/~me 05/! 1/99 13_ 14 Collected Date/Time 05/06/99 09.30 R~:eived Date/Time 05106/99 10:35 Technical Director: Stephen C, Ede Relea.~ed ~y~ Total CoLiform 0 Ni[rate-N 3.06 O.50o coL/lOOm~ ms/L SH18 ~2228 051Q0199 KAP