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Home My WebLink AboutPINES LT 2APines Lot 2A GREATER ANCHORAGE AREA BOROI!"~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM LEGAL DESCR,PT,ON SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY / GALLONS. MATERIAL ¢f~'¢ NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH DEPTH SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL NEAREST LOI LINE SEEPAGE PIT: '7')/?¢4~4i~/_.~/ z. o6 OUTSIDE DIAMETER OR WIDTH DISTANCE FROM WELL ~' ,~;t~)¥,c'~(IV O/VTOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ., LENGTH , DEPTH , BUILDING FOUNDATION 2-. ","g~ sc~. FT. TILEfl~RAJ~ FIELD: TOTAL LENGTH DISTANCE FROM WELL ~'-'"'""~LLb4DATION ,.l~E~R~S'T-~T LINE , OF LINES , ABSORPTIO~'"~'- SQ. FT. LENGTH OF EACH LINE ~'~-~- DE.P/ OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN, ABOVE TILE__ DISTANCE FROM WATER WELL: TYPE'~.)/(2/L(.. ~-'/~ DEPTH , BUILDING FOUNDATION. __SAMPLE. , NEAREST NEAREST SEPTIC ~,j ,~ SEEPAGE ~.) <.~ OTHER , SOURCES LOT LINE , SEWER LINE , TANK , SYSTEM , CESSPOOL DIAGRAM OF SYSTEM DISTANCES: DATE Lot APPROVED¢ ¢~ H EAL~[H AUIHORI1Y GAAB*HD-2 GREATEF 327 Eagle St. ANCHORAGE AREA HEALTH DEPARTMENT Anchorage, Alaska 99501 OROUGH 279.2511 Case No. SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT ('~g"-'~-~¢.,'//~'~dd..~.¢..c<' ~ ' RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH PERCOLATION TEST RESULTS_ , SEEPAGE PIT. , DRAIN FIELD TO BE INSTALLED BY_ C//¢q~ C'/~z;C/~"z4-~ ANTICIPATED DATE OF COMPLETION ,OTHER. BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS ~ ~'~O'~"~'t'L'~/ , PERMIT TO INSTAkk A ,//~"¢C~ AS DESCRIBED BELOW. SIZE OF UNITTO DESERVED SEPTIC TANK SIZE "~ _TYPE~~" '"~' SEEPAGE AREA__ TYPE DIAGRAM OF SYSTEM DISTANCES: I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the DATEab°ve desfw/~cl'ibed~cc system is in accordance wit/~ f~-/~ ~/'~f? h said code. '/~'~~/[ ¢4~'.~.~*eC~'~--'~-"N~~ ~ ~ / APPLICANTS SIGNATURE #1: Time Date Insp ~UNICIPALITY OF ANCHORAGE DEPARTMEN} JF HEALTH AND ENVIRONMENTA, PROTECTION 825 L Street, Anchorage. Alaska 99501 264-4720 Date Received: October 6, 1977 10:00 a.m. #2: Time #3: Time 10-10-77 Monday Date Date Willis Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: First National Bank of Anchor~g~ Mailing Address: Post Office Box 720 Phone: 276-6300 e Property Owner: Mailing Address: Lea/Bruce Purcell 4611 Cascade Circle Phone: 243-4785 3. Legal Description: Lot 2 Pines Subdivision 4: Single Family Residence: (x) Multiple Family Residence: ( ) Number of Bedrooms: Number of Bedrooms: Four Well System: Permit # Construction Individual well (x) Community/Public System ( ) ~ Depth of Well 187' Well Log on File ~--~, ~ ~ Bacterial Analysis e Sewage Disposal System: On-site System ( ) ? Public Utility Permit # Installed ~~ Installer '~- /O00 Manufacturer O~ ~ Septic Tank Size Absorption Area ~ ~-~ Soils Rate Distances: Well to Septic Tank to Sewer Line to Nearest Lot Line Nearest Lot line Material to Absorption Area ~ ~ Absorption Area Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 2 Pines Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ) Approved: Date: Disapproved: Date: Department Worksheet: ~j_~ t MUNICIPALITY OF ANCHORAGE , . ~,. ~ , Prot, edtion. ' ~' ~ %, / Department of Health and Environmental /'i/~'~ii,/ 825 L Street, Anchorage, Alaska ~99'5'0'~ ". "'~ hReqmest ~oz ~uova~ o~ ~d~v~dmal SeNeu a~d Wa~eu ~ac~es Mailing Address, Z~ ~'ll ~d&Q[.,.~ ~v-~ Phone: Name of Buyer: Mailing Address: Phone: Lending Institution: Mailing Address: Phone: Realtor/Agent: Mailing Address: Phone: Legal Description: Street Location: 6. Single Family Residence: (~) Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: o Water Supply: *Individual Well (~) If Individual Welt, well depth Public/Community System ( ) If Community System, name of system Sewage Disposal System: On-site System ( ) Public System If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. 3/77 Form Approved FHA Form 2S'!3 u. S, DEPARTMENT OF IIOUSING AND UROAN DEVELOPMENT Budget Bureau No. 63-R296,8 Rev, July 1958~ FEDERAL HOUSING ADMINISTRATION HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--tO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. MORTGAGOR OR SPONSOR PROPERTY ADDRESS SUBDIVISION NAME T~OCK NO. LOT NO, ~ Cfln ~lc ~ other aroa be made Into TOTAL NUMBER; BASEMENT New installation additional b~oms? LIVING UNITS BEDROOMS BATHS (1~ Yes, how mony~) WATER SUPPLY BY: SYSTEM DESIGNED FOR ~ Public system ~ ~mmuniW system ~ Individual SEWAG(DISPOSAL ltl PART fl.--TO BE COMPLSYED BY HEALTH DEPARTMENT HE~TH DEP~T~ENT I~PE~OW~ ~KETC~ f .... ' ' IIIIIII ....... LIIIIIII-III~IIIII IIIIllllllll ........... ~ i i 1 I I FI I I I I~1 I ~ I Il I I I ~J I I I I~~E ..... I I I I I I I I I I 11~11 I I I I I I I I I I I IT[7 ~FFI I - I I I [ ~11 I [ I [ [ I I I I I I I [ 1~111~ - I 1.1 [ / I I I ] I I I I I ] I~l I I I I I I I ~~1-I I I I I I ] I I-I I J I I I I I/I I I I I I lID I I I I I I I I Il I [ -- - ] ~ ] ] I~ 1 I I I~~-I~-[T~-I I I I I'-IW-I~ .......... ,,,,, --- It H III I~]1 ~ ~11 : - lll I I I LI I H,,, ,,,,, ~~ I I II I I I /I LL~ I I I I FUI~ ................... ..... ~---~2~ I I I I I I I I~1 I I I [ /I I[~LI I I I I I ~ ........ -- I I ~ I I Il I I I I I I I I 11/I III I I I I FI [~ FFI III I I : I I II 4~ I [I Fl II lq~ I I I I / /I_~L~LII Ill I [ I , Il ---4-_L~_[[I] [][[ ILl ~[ ] ]Iii [[l~~ [[[ -- / REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY TREATMENT consists of [] Septic tank. [] Cesspool. Septic Tank: Distance from well,___ Total liquid capacity, Inside length, Cesspool: Distance from: Well, Inside diameter, .feet. Material Number of compartments ~ gallons. Capacity inlet compartment,__, gallons. feet, Inside width, .feet. Liquid depth, feet. feet; fl,undation, feet; nearest lot line at [] front, [] side, [] rear, feet. Depth, feet. Liquid'capacity, .gallons. Lining material 2. 3. 4. 5. REQUEST ~OP, APPROV^L OF INDIVIDU^L SEW^GE AND WATER FACILITIES (Fill out in Triplicate) ~ ~ ,. , . ,~ 1 ..//? ,~ -: ,,l. x9 :,~-K~- ~ e or person ~equest~ng approval.~~ ~L~,- Numb,,. c,~ ~,drooms in house... ,~ ~ .--' ,~' Water, Analysis: b. De'temsenl: ...... . W~I I data: /? c. Casing Size _/~p._ ~ . d. Distance from well to closast existing or proposed: 1. Sewer lin%. , 2. SeptJ c t ank~~. 6, Other sources of possib~e co~tamination~ J-,e,~ c~eeks~ ~ake~ ho,scs, barn, dmalna~e ditch, etc, c. Hame of septic tank . manufac'tu~em ~ ~ 1. If "home made" show dlagmam on reverse side of this fomm. P p y..Ltn. ~ __to house fotmdation e, Per. co]nt2o~ Test '~r,esults f. Percolation Test performed by Use the reverse ,side of this form to show dia['ram. Diagrar~ should include ~'.the following information: p.rope~ty lines; ,we, ii location, house location, ,~p~ic tank location, disposal area location, location of percolation test, aad dJrectlon of ~round slope, The ~'-~:~on on this form is true and correct to the best of my knowledge. ~'i~{a~ure of Applic~n~ '-~ Date Signed FILLED OUT BY HEALTH DEPART~-~ENT PEI~SONNEL ......... ~6'llowin?Tbe above con~Ji.~'ionsdescribed sanitary: facilities are hereby, approved~ _sub,ject to the The above described sanitary facilities are disapproved for the following reasons| Approval is valid for one year following the date of approval. CPJ: cw :L 3 WATER SUPPLY BYI _[~] Public system SEWAGE DISPOSAL BYz [] Public system o^~M~r~, [[ I New installation ~]Ves [~No ]Community system additional bedrooms? (If Yes, how many~) []Yes f-~No [] Individual [] Community system [] Individual PART II.---TO BE COMPLEYED BY HEALTH DEPARTMIENT HEALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the [3 State ~ County [] Local Department of Health that this individual water-supply system [] is [] is not satisfactory as a domestic water supply for the subject property. It is the opinio,~ of the ~ State [] County tern with proper maintenance: [~] Can be expected to function satisfactorily, and is not likely to create an insanitary condition DATE ~ S'G~ATU",E' ". il,' .-'/ Eob. 10~ 1970 .. '~i!5,"(:/ [~ Local Department of Health that this individual sewage-disposal sys- ]Cannot be expected to function satisfactorily ,,'/ [ TITLE f . . ~,~,~ NOTE: Tho i~eafth fluthorl~ should complelo the ~pro~rlol~ opinion ~l~t~ment u~ove spaces provided. / U~e of tho~bove grid 'for Health Department Inspector's shetch as well as uso of the back of thi~ form Is at the option of the heal~ auth ~j~y. PART III.~FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the Individual water-supply system be considered [] Acceptable [] Not Acceptable Sewage disposal be considered [] Acceptable [] Not Acceptable. SIGNATURE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPpILy AND SEWAGE DOSPOSAL SYSTEM I~--~ CHIEF ARCHITECT ] DEPUTY FOR CHIEF ARCHITECT FHA Form 2573 Rev. July I~S8