HomeMy WebLinkAboutSOUTHPARK #2 BLK 3 LT 36Onsite File
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MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://wvAv.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP221323
Work Type: SepticTank Upgrade
Tax Code Number: 02050234000
Site Legal Address: SOUTHPARK #2 BLK 3 LT 36 G:3236
Site Mailing Address: 15631 STANWOOD CIR, Anchorage
Owner: JELINEK STEPHEN K &
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date
�J�111CI1t .S
JG, Cin
® � v
llepai-tment
Lot Size in Sq Ft:
Total Bedrooms:
8/30/2022
8/30/2023
25863
❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
• Waterline is to be located prior to construction to ensure the required separation is being met.
1. n II
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Received By:
Issued By: (/U
Date: 8/30/2022
Date: d 2
4
Development Services Department xj Phone: 907-343-7904
On -Site Water & Wastewater Section - Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 020-502-34
Property owner(s) STEPHEN K JELINEK Day phone
Mailing address 15631 STANWOOD CIR, ANCHORAGE, AK 99516
Site address 15631 STANWOOD CIR, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) SOUTH PARK #2 BLK 3 LT 36
Legal description (Township, Range & Section)
Lot Size 25,863 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) x❑
(w/wo ADU)
Septic Tank
M
Upgrade M
Duplex ❑
(D)
Holding Tank
ElRenewal
❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
Ignature of property owner or autnorizea agent)
Permit/Rush Fees: 0225
Date of Payment: L3 /Z �2Z
Receipt Number: O/2 / 70
Permit No. DSP 22132"'
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
August 10, 2022
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC TANK UPGRADE PERMIT
LEGAL: SOUTHPARK #2 BLOCK 3, LOT 36
The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic
tank on the above referenced lot. We propose to install a 1500-gallon steel tank out of
precaution per the attached design to serve the existing 4-bedroom residence. Although the
6/4/1994 soils log #4 shows no groundwater to 18.5MOA sites other test holes on the
opposite side of the house having groundwater. MOA has requested a steel tank in lieu of the
HDPE tank due to these existing soils logs and potential groundwater at 8-10 on the other side
of the lot. The lot and area are served by public water and the waterline will be staked by a RLS
prior to construction. The design will not impact any of the neighboring properties. Please
contact us if you have any questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221323, Deb Wockenfuss, 08/30/22
FIRST WATER CONSULTING
NO WELLS WITHIN
200' OF PROPOSED
SEPTIC TANK
SOUTHPARK #2 BLK 3 LT 36
DESIGN DETAILS:
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221323, Deb Wockenfuss, 08/30/22
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Municipality of Anchorage Page
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: <~W~/69 PID Number:
Name:
L~ ,~e /~ Wastewater System: ~ New [] Upgrade
Address:
7~/~ /~o,~-~o~- k/,,), ~'~ ABSORPTION FIELD
p,-,cn~.: No. of B~.~rooms: J~ Deep Trench [] Shallow Trench [] Bed [] Mound [] Other
LEGAL DESCRIPTION soil Rating: Total Depth from original
~, 4~,.~' GPD/Sq. Ft.
Lot: Block: Subdivision: 9epth to pipe bottom from original grade: Gravel depth beneath pipe
Township: Range! Section: Fill added above original grade: Gravel length:
.... , ~ Ft. 7~' Ft.
Number of lines:
Distance ~etween lines:
Gravel width:
WELL: [] New [] Upgrade
~-.~' Ft. / "-'"'-" Ft.
Classification (Private, A,B,C): ~'X'/E3Z, Total Depth: Cased To: Total absorption area: Pipe material: F~/0 ~>~'~.F'.
~43/4d~ ~,'XJ / 7'~ Ft. Ft. /i-~P~. ? SQ. Ft.
Driller: Date Drilled: Static Water Level: Installer: Date installed:
Yield: Pump Set at: casing Height Above Ground: TAN..
GPM Ft. Ft.
SEPARATION DISTANCES ,J~Septic [] Holding [] S.T.E.P.
TO Septic Absorption Lift Holding =ublic/Pdvat¢ Manufacturer: Capacityin gagons:
From Tank Field Station Tank Sewer Lines ~/U~.,~O~ [~.. ~ T'/=:~r.~ ~..
Material:~.7.~.E,/.. Number of Compartments:
We~ /~ '-/- /Od ~ ~ - 2.~fl-
Surface '~- '+ LIFT STATION
Water /Od
Lot Size in gallons: Manufacturer:
Line /0 ~ "/" /a ~'~- ~ "-"-----
''Pump on" level a~off" level at; High water alarm at:
Foundation
/
Curtain
Drain
Remarks: BENCH MARK
7~m~ 7~i> o~ ,~oo,,J~,~T~o,d
/do .do Ft,
ENGINEEB;S~ SEAL
a & s ENGINEERING ~¢.,,~ ~ ~. ~.~
17034 Eagle River Loop Road, No. 204
Inspections performed by: Eaale R~ver," Alaska 99577 Dates: 1st 77o/q4 .'~
Department of Health and Human Services approval ~ '
Reviewed and approved by'. ~_J~' -~ Date: 7- ~- 7*
72q)13 (Rev. 9/91) MOA 25
Permit No.Sw940169
Page 2 of 2
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 Descriptic~nO:UTHPARK SUBD. ADD.#2; BLOCK 5, LOT 36 PID No.: 02005259
NEW
NEW
1250 GAL
(~o5~
qo6)
=:~,80.6' NO WATER FOUND
A 13 C
FC-O 13.0~ ,~8.;6~--
COl 22.5 20.0 -
C02 22.0 27.0 -
CO3 21.6 29.0 -
C04 22.0 36.0 -
C05 36.5 49.0 -
CO6 39.0 -- [2.0
MT1 29.0 [6.0
250 GAL. SEPTIC
)BLCO 4 BD~M
HOUSE
NEEW
PROPERT SERVED BY A i
COMMUNITY WATER SYSTI{~VL
72-013 A (1/93) *
N
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
0N-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW940169
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:HALL LESA ADELE &
OWNER ADDRESS:7510 FOXRIDGE WAY #C
ANCHORAGE, AK 99518
DATE ISSUED: 6/08/94
EXPIRATION DATE: 6/08/95
PARCEL ID:02005239
LEGAL DESCRIPTION: SOUTHPARK ADDN 2 BLK 3 LT 3
6
LOT SIZE: 25863 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PEILMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
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 AAID 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 343-4744 (24 HOURS)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY: ~ DATE:
. JUN-~8-'94 WED 15:08 ID:S&S EN~INEERIN~
TEL N0:~94-1211
~569 P02
June 08, lg~4
ROBERT ~:HAt~ER,
ROGER SHAPELY,
OIVIL ENOINEEI~
(907) 094-g979
PAX 094-13t I
Italia wAmn
~=-~cE: Sout~park Sul~tvision W2; no~ 36; ~lo~k 3
Two test holes wera
14~ ~ ~rt ~igf~l on ~y 21, 1~ ~ ~e ~ S ~ S =ecen~ly. The
si~ pl~. ~e ~nitorin9 t~s within ~e tes~ holes w~r~ ch~k~ o~
J~e 03, 19~
~n on ~ at~ch~ site ~. ~e~ a~ ~ protec~ive wail
This prope~cy is served ~ a Community Water ~yste~. We do not
anticip&te ~¥ adverse effects o~ neighing pro~er~ies by
tns~allation of ~he p~o~ ~ep~ic
if you have any ~uestions, or r~/~ire a~itionnl information fo= your
~iew, pl~e ~n~ot ~.
~'~ S~, P.~,
AITIWA~I~
17034 NORTH EAGLE RIVER LOOP '~ SUITE 204 * EAGLE RIVER. ALASKA 99577
ST_~.A_NW~O_OD _ ___CIRCLE
NV'ld 3IlS
,OCj =.,,L't- ,,
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: ~----~;~-1~1~---- J~¢'~'~"~ Township, Range, Section:
1
6
7- ~M
9 -.~.
WAS GROUND WATER
10 - ENCOUNTERED?
SLOPE
SITE PLAN
11
~' IF YES, AT WHAT
DEPTH?
12
13 Monitoring?
G~ross ~ Net Depth to Net
I --, ~: ~ ~H,A ~,1.,_" 7.4?
~ I "z..:~-/~ " (a" clX,,
I ~:~ t~,~.
,~..~*.(~d.d~es/inch) PERC HOLE
TEST RUN BETWEEN ~,, FT~A~ID FT /
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES [N'EFF~ON THiS DATE. DATE:
72-008 (Rev. 4/85}
L~^L
~ / ~ ' I._.~T_~-.~-~~ ,
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
Township, Range, Section:
SLOPE SITE PLAN
PERFORMED FOR:
LEGAL DESCRIPTION: L-"~!
8
9
10
11
15 (.f~J
16-
17-
18-
19-
Gross Net Depth to Net
Reading Date Time Time Water Drop
i :o;;z ?,~ ~ 2 ,,,',r ,, -
:],z lO q~'~ I"
: ~,z to ,c,~" /,,
20 - ~'
PERCOLATION RATE l0 (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND ~ FT
' ,.
COMMENTS (4
PERFORMED BY' ~1~ pl... AI..I.. n~e~ I / ~ ~ CERTIFY 3HAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN E. DATE:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502~0650
SOILS LOG -- PERCOLATION TEST
,
SLOPE SITE PLAN
PERFORMED FOR:
1
WAS GROUND WATER
10 / ENCOUNTEREDZ
] 1 ~ IF YES. AT WHAT
14-
15-
16-
17
18
19
Gross Net Depth to Net
Reading Date Time Time Water Drop
;io Io ~' '/;~ lS/~''
'. fig I0 '~" t//~''
COMMENTS TEST RUN BETWEEN .,,~T AND ,~ FT
$ & $ ENGINEER,NG ~'/
JiM.J4 Eagle River Loop Road No. ~a /.,~'~,-~/ CERTIFY THAT THIS TEST WAS PERFORMED iN
PERFORMEI~JJe ........... ~;a t1~,,~11
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUJDELINE~'~I'~yCT ON THI~ DATE. DATE:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRmT,ON: l,....,~1//~'~l' ~_~,X./..j.~/~.- ~.,~ ~ Township, Range, Section:
~ SLOPE
1
2
SITE PLAN
5
6
7
8
9-
10-
11
12
13
14
15
16-
17-
18-
19-
20~
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
~onilori~g?
s
L
O
P
E
Gross Net Depth to Net
Reading Date Time Time Water Drop
, i?~,.~ - ly~,, ~
: ~g ~ ~'/¢' ~,,~"
'.~ % 4'/¢" ~/~"
COMMENTS S & S
17034 ;~,1~
ACCORDANCE WITH ALL STATE AND MUNICIPAL
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. ff
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
0~o o5~ -~
1. GENERAL INFORMATION
Complete legal description
Lot 36~ Block 3i Southpark Subdivision' 02
Location (site address or directions)
Property owner
Mailing address
15631 Stanwood Circle
Anchora~% AK
St~v¢ Jelin~k Day phone
7510 Fo;~ridge Way #2C Anchorage, AK 99518
243-8422
Lending agency
Mailing address
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
NOTE:
4
Individual well
Community well XX×
Public water
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:
XXX
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system,
72-025 (Rev, 1/91) Front MOA~I
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 invest_~ation 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.
Name of Firm $ & s ENGINEERING
17034 Eagle River Loop Road No, 204
Address ~.,.I. Rivar. AIn,d~'n
Engineer's signature
Phone
Date
DHHS SIGNATURE
; Approved for ,/
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Cedificates based only upon the representations given in paragraph 5 above by an independent
professional 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 engineer's work.
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~-~, ~., ,~L~?'f/h-~¢'~)¢ ,-,~//D ~-2_ Parcel I.D.
A. Well Data
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Cased to
If(~, B, or C, attach ADEC letter. ADEC water system number
/"J//~ Date completed /~/: Driller ,AJh
/~/'~ ' CaSi"g height
Wires properly protected (Y/N)
FROM WELL LOG
/
Date of test
Static water level
Well flow
Pump level1
SEPARATION DISTANCES FROM WELL TO:
Septic/hcldi~ej tank on lot
Absorption field on lot
Public sewer main
Sewer service line /*"*//~
AT INSPE/CTION
g.p.m.
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout ,f~/'~'
Petroleum tank ~//~
WATER SAMPLE RESULTS:
Coliform d/,~
Date of sample:
Nitrate
/'///~ Other bacteria
Collected by:
B. SEPTIC/HO-' D:NG TANK DATA
Date installed ~ -/~-/'~~
Cleanouts (~)
High water alarm (Y/~
Date of pumping
Tank size I ~r_.~ Compartments
Foundation cleanout ~1) ,Y Depression (Y/N)
hJ//~t Alarm tested (Y/N) /d/~4
/'~E~,~ Ti~ Pumper /~/h
2
SEPARATION DISTANCES FROM SEPTIC/H~)EDING TANK TO:
Well(s) on lot /'~//~ On adjacent lots
To property line /6 '~ Absorption field
Surface water/drainage I(~0 ~
~.0C~ ~/' Foundation
~ 4- Water main/service line
72-026 (3/93)* Front CONTINUED ON BACK PAGE
C. L!FT STATION ~j///~ ~
I-~,~2tsWa~eorAal~re (mt j~cV~,c c d e s (y/~ ) -"-~.. ~~Jes~ested
SEPARATION~O~ TO: ~
Well o~J~ _On adjacent lots __ __ Surfa~r__
D~. AB"~ SORPT,ON FIELD DATA ., ,.,- ,"",-~ ~-'~'~~.,,
Length Width
Total absorption area /.~ 47 Cleanout present (~N)
Date of adequacy test A~,/~/ ,/~..W ~.//.r. Results (pass/fail)
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N) ./%J/,~
Gravel thickness
~i¢" ' Total depth / ~'
Depression over field (Y/i'~ /U/
for ~- Bedrooms
After test ,/~//~
If yes, give date '"%//'~
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot /~///~-
To building foundation
On adjacent lots
Surface water
Curtain drain
On adjacent lots ~ o~ ~'~
Property line /0 "/-
l6/ 'g' To existing or abandoned system on lot /"J//~
~ {~ ")- Cutbank .~0 './ Water main/service line /0 ~
/ 0d '¢ Driveway, parking/vehicle storage area /d ~.J
E, ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect
ROBERT C. COWAN
CE - 8801
HAA Fee $
Date of Payment
72-026 (3/93)" Back
Waiver Fee $
Date of Payment
Receipt Number