HomeMy WebLinkAboutCINERAMA TERRACE BLK 3 LT 8Onsite File
Municipality of Anchorage Page of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 i Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: tA)! -I O37 "� PID Number: Oad — (333
Name:Ljc
1 CO (.o61157/uGf /or)
Wastewater System: 9New ❑Upgrade
Address:
gala l%Qn ria ai AnGh. dK 99507
ABSORPTION FIELD
Phone:
No. of Bedrooms:
3
WDeep Trench O Shallow Trench O Bed O Mound ❑Other
LEGAL DESCRIPTION
Soil Rating: 0
• GPD/S . Ft.
Total Depth from original grade: IL
.S
Lot: Block: Subdivision:
% r1a/ aoi Tery
Depth to pipe bottom from original grade:
3-5 Ft.
Gravel depth beneath pipe
6 Ft.
Township:
Range:
Section:
Fill added above original grade:
I+Ft.
Gravel length
� C_� Ft.
WELL: ❑ New ❑ Upgrade
Gravel width:
Numberollines:
I Distance between lines:
Ft.
t
Ft.
Classification (Private, A,B.C):
r V0. �"e
Total Depth:
j T/ Ft.
PCasedbTo: 8-k.
Ft.
Total absorption area: ^,Pipe
�` �SO. Ft.
material:ynP/
5-rM �W3 gDriller:
rill `n
Dale Drilled:
-lS-DO0
c r Level:
Ft.
Installer:
Q w er-
Dale installed:`.lam - j �% — DO
Yield:Pu Set at:
6 t
Casing Height Above Ground:
TANK
GPM -I nkn to Ft.
a Ft.
SEPARATION DISTANCES
KSeptic O Holding O S.T.E.P.
To
From
Septic
Tank
Absorption
Field
LIR
Station
Holding
Tank
Public/Private
Sewer Lines
Manufacturer: �7 V"Ce�
Capacity in gallons: D OO
Well
of
1
Material:
Number of Compartments:
Surfac
Water
Oft
100-f-
LIFT STATION
Line
Line
J (\
"'(
���
Size in gallons:
Manu rer:
Foundation
1
rr
L 1
V
"Pump on" level at:
"Pu I" leve
Fligh water alarm at:
Curtain
Drain
Dh
� O
✓/
Pump Make el
Electrical Inspections performed by:
Remarks:
BENCH MARK
Location and Description:
To a� 611 - slab
P0Al r1 6
Assumed Elevation: 00 Ft-
ENGINg#k% ' L
�l
-SOF
S & S IENGINEERING
'�. �•;= tw
17034 Eagle River Loop Road, NO.M
Inspections performed by: Eagle River, Alaska 99577 Dates: 1 st 17- 00
A
"'• """�'"`'"'°'�
2nd 8 I9 -OD
A�•"'`
;.. :..'^.��;.
••ROBERT
�i/1Q�
C. COWAN
�l
Department of Health and Human Services approval
CE- 8801
Reviewed and approved by:
......
Date:
-u1J (Hev. 9/91) MVA 25
PERMI? NO SW990574 PAGE 2 OF 5
D ........ Mu~n~ip.~!i .t y_o. F .A.O£ h.o r..o g.e'
I-PAN/MI-N/ (il- HI-AL/H ANL) HUMAN SERVICES
ENVIRONHENTAL SERVICES DIVISION
P.n. Box 196650 eAnchop~ge, Al~sk(~ 99519-6650® Telephone, 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LECAL LOT 8, BLOCK 5, CINERAMA TERRACE
P.I.D. NO.
020--055--24
LOT 7
~C02
NEW I000 GALLON
S£P?IC TANK
100' WELL RADIUS
LOT 9
FCO
CE-8801
PERNMIT O. SW990374
PAGE 3 OF, 3
X
AOF HEtTH AND HUKAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P,0. Box19 6650 0 Anchorage, Atasko. 99519-6650 0 Tet hone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WEL INSPECTION REPORT
LEGAL LOT 8, BLOCK 3, CINERAMA TERRACE P.I.D. N0. 020-033-24
FINAL GRADE
IIIIIIIENJEN
AS
I l- ( U.0
ST1
ST2
86.4"Z NEW 1000
GALLON
SEPTIC TANK
-101=82.3'
'02=82,1'
A
NO WATER POUND
70.3' B.O.H.
91.2'
y
FR~ : PHONE NO. : Oct. 30 2000 01:29PM Pi
Municioality of Anchor. age
oenartme~t of Health and Human Services
~ '- 825 'L' street
P.O. Box 19~50 Anchorage, Alaska 99519-665
htr p:l/www ~.a~.ak.~
Mawr
?e~it Number: ~SW ~ Date of I~ue: l~-gg Parcel Identification Num~e~ 02~33-24
~te S~: ~ ~e Complete: g-l~ ' Is we~ I~a~ at a~rov~ p~k lo~d~?
Cine~me Te~ce Big 3 Lt 8
g312 Vangua~
C~g ~: steel
0 2'
.stick-up
gravelly silt 2 15
bedrock 15 147
RECEIVED
~O.V 29 ~OCO
MunlC~paht¥ ot Anchorage
Dept. Health & Human Services
W.~l'hickncss: '[025 inches
Diameter: _6 [nchc-s Depth: 2..~0 fe~t
Liner Type: ~
DL~meter:. ~ inches Depth: feet
Casing stlckup above ground: _2 feet
Static water level (bom ground lever): 20 feet
Pumping lcvel:~47,fc~t after
_2 hours pumping _~ gpm
Recovery Rate: ~ gpm
Method of Testing: alrl~
Well Intake Opening Type:
[] Open End [] Ope~ Hole
[] Screened Start ,- feet Stopped , fe~t
[]perforations Stnrt __feet Stopped__feet
(;rout Type: ~entonite # R. Volnme: ~
Depth: Start 0 £eet Stopped ± fe~t
Pump; lnt~ke Depth _ . feet ..
Pump sfzc ~p Brand Name
Well Disiufected 0'pon Completlon'! [] yes [] No
Method ofDisinfcctlon: Clqrlne Tablets.
Comments:
Well Driller:. Alpine D~flling & Enterprises
PO Box ~10496
· . Anchorage AK 9951.1
Atteatlon: The well driller shall provide a well log to the properly owner within 30 days of completion and the propcr~
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Sen/ices
On-Site Sen/ices Program
825 L Street, Room 502
P.O. Box 196650, Anchorage. AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Oct 04, 1999
Expiration Date: Oct 03, 2000
Permit Number: SW990374
Legal Description: ClNERAMA TERRACE BLK 3 LT 8
Design Engineer:. 0003 S & S Engineering
Owner Name: W~lco Construction
Owner Address: 9312 Vanguard
Anchorage, AK 99507-
Parcel ID: 020-033-24
Site Address:
Lot Size: 71334 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
[] Disposal Field [] SepticTank [] 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 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.
ROBERT C. COWANo P.E.
September 28, 1999
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694421
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 8, Block 3, Cinerama Terrace S/D
It is requested that you issue a permit to install a septic system and drill a well to
serve the proposed three bedroom dwelling on the referenced property.
A test hole was excavated and a percolation test was performed. The approximate location
of the test hole is located on the attached site plan. At the time of excavation 9/15/99 water
was not found.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the adjacent
properties.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/jhm
Enclosure
RECEIVED
SEP 0 1999
MUNICIPALW/OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
17034 NORTH EAGLE RIVER LOOP * 8UffE 204 * EAGLE FINER, ALASKA 99577
~: LOT g, BLOCK a, CINERAMA TERRACE
~...M. I ~.c.c. I 9-~9-99 I , OF
,?o~, ~ ~ ~' , ~ X~ / / / / WELL~ ~ '~.";~. ..'~.?~
m ,~... 0.8 GPD/SQ.~.
CO~ .... ~ ~ .
(,.~-~/'~'~ DEPART.MENT OF HEALTH & HUMAN SERVICES
~ · 825 "L Street. Anchorage, Alaska 99502~650
SOILS LOG -- PERCO~TION TEST
LEGAL DESCRIPTION: ~ ~., ~ ~ ~/~ Township, Range, Secbon:
WAS GROUND WATER
ENCOUNTERED?
IF YESo AT WHAT ~//.4'~ oL
DEPTH? p
/ E
SLOPE SITE PLAN
ae~t~ lo W~er ~e, t~ ~ ~
Idonitorin§? .~"'? I~at~
2-
3-
4-
5-
6
7
8
9
10
11
12
13
14
15
16.
17'
18'
19.
20-
Gross Net Depth to Net
Reading Date Time Time Water Drop
- -
~0 ~,~,~ ~ ~/F" ~ '/~"
PERCOLATION RATE f~- (mmute~',nch) PERC HOLE DIAMETER
TEST .UNSETWEEN ~ ~TAND 4; FT
COMMENTS
ACCORDANCE ~TN ~k ~AIE A~D ~IPAL GUIDELINES IN EFFECT ON THIS DATE. DATE;
72~ (R~.
Municipality of Anchorage •
On-Site Water and Wastewater Program
tS - (907) 343-7904
i" -
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 020-541-14 Expiration Date: l -' LI^CR
1. GENERAL INFORMATION
Complete legal description Cinerama Terrace Block 3 Lot 8
Location (site address) 16031 King's Way Dr
Current Property owner(s) Bank Of NY Day phone 261-7603
Mailing address same
Real Estate Agent Bob Brock RE/MAX Day phone 261-7603
678970�
2. TYPE OF DWELLING:
® Single Family (w/wo ADU) a JUL 19 zuld
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
68L9.")�
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class C Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Received by:
Date: ?AV/ct°
COSA to be released to the engineer,unless othe ise requested by the engineer.
COSA Fee $ 5 210 Date:
Date of Payment i-12618 Date of Payment
Receipt Number C) .51 ) Receipt Number
COSA# 05C l21353 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 NorthRim Engineering Phone 694-7028
Address PO Box 770724, Eagle River
Engineer's Printed Name Steve Eng Date 7/19/2018
6. DSD Sr .IGNATURE
^ 6"
E
System #1 Approved for 3 bedrooms. `cc=j.50
;y1 �,:. Steven '.',. CIl^
System #2 Approved for bedrooms. : r.- '256 (((,,, ,cF,rso
Disapproved. `` 7��6/ •w`�
Conditional approval for bedrooms, with the following stipulatioris:'� 1?-•
ON SITE
WATER AND
WASTEWAI1 R
PRO/GRP" c.
By: 1 / i
Original Certificate Date:
The Municipality of Anchorage Devlopment Services Division(DSD) Issues Certificates of On-Site Systems Approval(COSA)based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS: •
COSA Checklist X Nitrate Advisory .
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 9.1-12.doc
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: C fre,nc.s ra 7;rtace_ os 44;11 Parcel ID:oZo 5'c/t,iq
A. WELL DATA ,p
Well type / If A, B, or C provide PWSID# Well Log (Y/N) y
DateWell Log (cr Sanitary seal (Y/N) / Wires properly protected (Y/N) 7/
Total depth N7 ft. Cased to 20 ft. B oc Casing height(above ground) zef in.
FROM WELL LOG AT INSPECTION
Date of test. /0/4/1 9 4- 2/1/e
Static water level Z C) ft. Zi ft.
Well production C g.p.m. 't‹.7` g.p.m.
WATER SAMPLE RESULTS: t
Coliform N(/ colonies/100 mL Nitrate o`Ir
a g mg/L
Arsenic NP ug/L Date of sample: R-t 12 Collected by: N t ►'"l
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material ‘S(5/437-10---7--are-f--1— Date installed ,f/ er/C o
Tank size /060 gal. Number of Compartments Z Cleanouts(Y/N)
i
Foundation cleanout(Y/N) y Depression over tank(Y/N) /✓ High water alarm (Y/N) A/
Date of pumping r-14-1-g Pumper A-
C. ABSORPTION FIELD DATA
Date installed d'HO0 Soil rating (g /ft2 or ft2/bdrm) 0. a System type Ti-
Length 5 z ft. Width 3 ft. Gravel below pipe C ft.
<D
Total depth %S ft. Eff. absorption area ‘04/
ft2 Monitoring tube y Depression over field
Date of adequacy test W21// e _ Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test 0 in. Water added /5O gal. New depth c? in.
Elapsed Time: (G min. Final fluid depth 2 in. Absorption rate >= 1/ -SG g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) (9'ti t<- If yes, give date
A
D. LIFT STATION /J A
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot /04' -1 On On adjacent lots /4-'0 `f
Absorption field on lot /OG /4- On adjacent lots /0 r fi'
Public sewer main /ao 'r Public sewer manhole/cleanout . /Da -1--•
Sewer/septic service line_ 25 '- Holding tank /O G e4—
Animal
f"Animal containment areas
Manure/animal excrete storage areas /OU f
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation /C TA
line l� Absorption field -f—
Water main O t Water service line / -�
/ Surface water (00 t
Wells on adjacent lots /' (f
ABSORPTION FIELD ON LOT TO:
Property line l O f Building foundation // 2 f Water main / 4 '�
(
Water Service line /6/ ('f Surface water ! 6c Driveway, parking/vehicle storage /0 �f
Curtain drain 1941 k., Wells on adjacent lots /00 `-4--
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and Y "'
review of Municipal records that the above systems are in ;;4,.
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name l�� /—� G f ,• i
Date 7//
COSA yellow sheet_2-6-15.doc
/ N
7
/V , -
06
,5 Wad °b
\e,01�,1.OgE � -441111111A ., ...N
f /
co. / A \
SEPTIC PIPES �P
0
p as Lot 7
�eJf,>' WELL P.
Jr
CONCRETE C? LP,
F
•
u J
4.0' PROW. ,),:p 9�6 �� ��
�d''� 0`.
/
f
RESIDENCE /
022.0' CANT 'ALot 9 \1.1x1.4' CANT G
10.7'x11.3' TSTORAGE _
10.1'x28.3' DECK
Lot 8
a'- 71,334 s.f. /
/ /
_-----
/
.-----
/
/ /
/ 2j6/
11.°%
10' DRAINAGE, T & E EASEMENTS S �% 1
/ / 1 Lot 3
/ 1
/
/
i — / 1
1
1
Lot 4
PLOT PLAN AS BUILT X SCALE 1" = 60. GRID SW 3241 Project No. 18-424/A1
11500 Daryl Avenue. Anchorage. Alaska 99515-3049
Lang & Associates , inc . (907) 522-6476 Phone 000DOp, 0
(907) 522-4625 Fax o O F ^ 0��
Professional Land Surveyors kenOlongsurvey.com v ,9
jonathanOlangsurvey.com �'� S ti
I herebycertif that I have surveyed the followingdescribed roe �a�P �'\ ••O�
LOT 8, BLOCK 3. CINERAMA TERRACE SUBDIVISION (PLAT No. 83-547) p* 49TH i� ��
Anchorage Recording District, Alaska, and that the improvements situated thereon are 0 VAVA
within the property lines and do not encroach onto the property adjacent thereto, thatno improvements on the property lying adjacent thereto encroach on the surveyed 4'� Hve,.......4.9)1i,
G. LNG :
premises and that there are no roadways, transmission lines or other visible Q c� , o A
easements on said property except as indicated hereon. OQ ' tD(72'1 +� Q�
04-e•
�"P6' •.LAS-5202.•• c.;p
Dated this the Day of _ , at Anchorage, Alaska ,o No..
�QORO�SSIONAL`a
It is the responsibility of the owner to determine the existence of any easements. 'OOOoo"`''a
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963