HomeMy WebLinkAboutNEVILLA PARK LT 30
GAAB-HD I
GR'=&TER ANCHORAGE AREA BOROI~mH
HEALTH DEPARTMENT
327 EA~LE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY
GALLONS.
MATERIAL
NUMBER OF
COMPARTMENTS
INSIDE LENGTH
INSIDE ~VIDTH
LIQUID
DEPTH
SEf:PAGE SYSTEM: SEEPAGE PIT:
NUMBER GE PITS / OUTSIDE DIAMETER
LINING MATERIAL__
NEAREST LOT UNE
DISTANCE FROM WELL
L/".,, TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
BUILDING FOUNDATION
~,2~ (~) SQ. FT.
TILl-_- DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
~'~FOUNDA ~ . NEAREST LOT LINE
DISTANCE BETWEEN LINES ~'~-~_ TRENCH WIDTH
SQ. FT. LENGTH OF EACH LINE ~'
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE fO FINISH GRADE
WELL:
TYPE. DEPTH
NEAREST SEPTIC
LOT LINE , SEWER LINE ., TANK
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WATER
SAMPLE
DISTANCE FRoM
, BUILDING FOUNDATION.
SEEPAGE
, SYSTEM. , CESSPOOL
DIAGRAM OF SYSTEM
, NEAREST
OTHER
, SOURCES__
DISTANCES:
"¢ /9"
~- C -4-q
H EA~ AUTHORI[Y
DATE APPROVED
GAAB-IID2
GREATEk
327 Eagle St.
ANCHORAGE AREA
HEALTH DEPARTMENT-
Anchorage, Alaska 99501
3ROUGH
279-2511
Case N 0. ~
SEWAGE DISPOSAL SYSTEM - APPLICA'i'ION & PERMIT
NAME OF APPLICANT_
RESIDENCE ADDRESS 813¢
LEGAL DESCRIPTION,
APPLICATION TO INSTALL: SEPTIC TANK_
TO SERVE THE FOLLOWING FACILITY
-.)~"o,, '2. ~.~d LOCATION OF INSTALLATION
,,SEEPAGE PIT ~ ,DRAIN FIELD ,OTHER
FINANCED THROUGH
PERCOLATION TEST RESULTS /"~"~r'/~ ANTICIPATED DATE OF COMPLETION o--"~'/~r-~ /~/~ ~'~,
,ELOW TO
THIS ms TO SERVE AS_~~
S~PT' C TANK S'ZE
DIAGRAM OF SYSTEM
/ ~'~Heaith Authority- '
I certify that I am familiar with the requkements of Greater Anchorage Area Borough Ordhmnce No, 28-68 and that the
above described system is in accordance with said code.
DA'rE. ~,/'7/~ ~ . APPUCANTSSlGNATURE ~ ~ o~ ~~-W'"--
~aev. Jul., ~95S · I~EDERAL HOUSING ADMINISTRATION Budget eureau No. 63-~296.8
t,. ALTH AUTHORITY Al)PRO. AL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL 'SYSTEM
INSURING OFFICE
MORTGAGOR OR SPONSOR
Char~ W. L~t
SUBDIVISION NAME
Nevilla Park
TOTAL NUMBER:
1
WATER SUPPLY
PART I.--TO BE COMPLETED BY FHA
MORTGAGEE
SERIAL NO.
r PRo~R~A~)~)RESS
81b8 Rau~ 8eaoml Ave.l
--J BASEMENT
I~ATHS J
j--] New installation
BLOCK NO. LOT NO.
adc tlona bedrooms? (If '(es, how many~')
Ptl~lic system
SEWAGE tlISPOSAL
[] Public system
[ J HEALTH DEPARTMENT INSPECTOR'S SKETCH
SYSTEM DESIGNED FOR
PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT
It is the opinion of the ['-1 State 1--1 County Department of Health that this individual water-supply system
E ~s~['-] is not satisfactory asa domestic water supply for the subject property.
It is the opinion of the [] State ['-] County ~ocal Department 'of Health that this individual sewage-disposal sys-
teen wit~ptoper maintenance:
~C'~ be [] Cannot be expected to function satisfactorily
expected
function
to
satisfactorily,
and
is not likely to create an insanitary cond3yion
DATE ~ $1ONA ~/ TITLE
NOTI~ The h~/alt~'~f~uthorlty should complete the approprlata opinion statement above and afflx' date, signature and rifle In the
spaces provided, f
health authority.
PART III,--FOR USE OF FHA OFFICE
1'O THE CHIEF UNDERWRITER:
I have reviewed the foregoing and the pertinent FHA Compliance Inspection Reporh and recommend that'the
Individual water.supply system I~: considered E] Acceptable [] Not Acceptable
[-~ CHIEF ARCHITECT
r . AHD IlWAGI DISIIOSAi, I