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~EATER ANCHORAGE AREA BOR~'LGH
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
N? 803
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~/'/J/~ j~O// ~)ag-~'g~J~2¥'^(.7.7( MAILING//~AD~RESS~''7r-- Z~ PHONE
LOCATION ~~XZ ~ ~ F~ LEGAL DESCRIPTION ~/Z/ XT~e ff~5/~
TANK:
SEPTIC ' /Y '~4'/i/~ ~ ~i'~/< ~'~ b~<~)*cl /}~j~e ;~3/~:~;'0,*
DISTANCE FROM WELL. ~(';;~ "-k
L,QU'D CAPACITY / Z e?( 9 GALLONS.
MATERIAL ~/'e~:4v (' NUMBER OF
COMPARTMENTS
"' 1~7~IDE WIDTH
INSIDE LENGTH~'<J 'TZ-'~' '''/~' ~' ~f (:>/ /~/ DEPTHLIQUID
SEEPAGE SYSTEM: SEEPAGE PiT:
NUMBER OF PITS OUTSIDE DIAMETER
LINING MATERIAl C[~?/n
/
NEAREST LOT LINE '~""/'f2 '~t~"' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
OR WIDTH
/
· DISTANCE FROM WELl
, LENGTH , DEPTH
BUILDING FOUNDATION
~:, '~7..~ (lC- SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL ,FOUNDATION -./"~"~'-- ..~AREST LOT LINE ,~,-~, ~.~INES ,
tR~C~H WLD!.H- ................
NUMBER OF LINES ,~'~-~. DISTANCE BETW~EEN LINES
DEPT~T~P' OF TILE TO FINISH GRADE
WELL: TYPE I~ ~ ~1 / , DEPTH
NEAREST
LOT LINE SEWER LINE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
DISTANCE FROM ~'-~' WATER
,BUILDING FOUNDATION. SAMPLE , NEAREST
TANK (/:~5) '"~' SEEPAGE OTHER
, SYSTEM ~ CESSPOOL , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
GREATE?'
327 Eagle St.
ANCHORAGE AREA ';OROUGH
HEALTH DEPARTMENT
Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
Case N o. ,Z..~-~.~
RES DENCE ABBRESS /"~/% ~//Z¢~'~'4 LOCATION OF INSTALLATION
LEGAL DESCRIPTION //~ ~ /'~,~Z~. / ~,'~
PHONE NO.
,OTHER
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS ~'~ ~¢/¢'~ , PERMIT TO INSTALL A ~¢z'Cf. ~./'~'~-~¢¢~ '
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
,,. SEPTIC TANK SIZE /~{'-~ TYPE/Jz~ ~ SEEPAGE AREA
DIAGRAM OF SYSTEM
DISTANCES:
with the requirements of Greater Anchorage Area Borough Ordinance No. 28~68 and that the
above described system is in accordance with said code. ~-~/-F'~ &,2t~/~ ,,~¢T~.
DATE ~t~ )/<¢~ APPLICANTS SlGNATURE'~ °--.-"4~ ~~.
CREATER a?-C?fORAGE ARI]A fsu~ou~u{
327 EAGLE STREET
ANCHORA~[:E~, ALAS~KA 99501
CASV'
Gray sandy gravel (GW)
Gray silt-sand mix (ML)
with scattered gravel
Was Ground ~later Encountez,ed?.~.!~o~
~f Yes~ At ~(~;.-~t Depth
COM~4ENTS: _~ _ _ ~ Sot t;om O~ Pit Or Trenc~
Test Performed By: R. E. Carlisle
D~,ta Certified By:
Date: ~ "~'~ .....
Deptth Te H20
Net Drop
Depth
Feet
2~
~JNICIPALI[Y OF Al..:.: ' ~
DEPARTMENT .: HEALTH AND ENVIRONN,. ',L. ! OTECTION
825 L Street Anchorace Alaska 9950
264-4720
#1:
Date ReCeived: October 10, 1977
me . : . ~
T %2: Time _~__,~_~ #3 Time '
Insp __ Insp ~ Insp . ~~
R~QUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: Alaska Statebank
Mailing Address: 310 East Northern Lights Blvd.
Phone: 279-7637
2. Property Owner: Harold Bradford
Phone:
Mailing Address:
3. Legal Description: Lot 2 Block 1 Hyatt Estates Subdivision
4: Single Family Residence: (x) Number of Bedrooms: ~____
Multiple Family Residence: ( ) Number of Bedrooms:
Well System:
Permit %
Construction
Individual well (x) Community/Public System ( )
Depth of Well Well Log on File ( )
Bacterial Analysis
o
Sewage Disposal System:
Permit #
Septic Tank Size
Absorption Area
On-site System (xk Public Utility ( )
Installed Installer
Manufacturer
Soils Rate Material
7. Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
October 5, ~IglPALITY OF ANCHorAGE
DEPT. OF HEALTH &
ENVJI~NMENTAL PROTECTION
OCT 1 0 1977'
RECEIVED
Type of Inspection:
CMRO VA_ FHA
CONV ~
Property Owner:
Mailing Address:~
Hmro]d grad¢ord
Out of Town
Day Phone:
3. Name of Buyer:
Mailing Address: 21767 A
4. Name of Lending Institution:
MailingAddress:310 [. No.
Fig Street
Alaska Statebank
Day Phone: Work Phone
Lights Blvd.. Anchorag~hone: 270-7637
752-2421
5. Name of Realtor or Agent:
Mailing Address:
6. Legal Description: Lot
None
Phone:
2, Blk. iv Hyatt Estates Subdivision
Location:
Dwellinm
Type of Facility to be Inspected:
Water Supply
Type of Supply: Public Utility
If Indivi~lual, number of dwellings presently served
If Individual, depth of well
No. Bdrms.
Individual
One
Sewage Disposal System
Type of System: Public Utility.
If Individual, date of installation
Individual (on-site) ×
ill Have To Call Mr. McKee at work in order to get into home, he has
the keys.
72-003(3/76)
Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description:
Lot 2 Block 1 Hyatt Estates Subdivision
Comments:
Affadavit Attached: ('~ Letter Attached: ( )
Approved: 1F2_C ,,/~.~ Date:
Disapproved: Date:
Department Worksheet:
f!
O~tober 26, 1977
Je~y Mc Kee
21~767 A Fig Street
Elmendorf Air Force Base,
Alaska 99506
Subject: Lot 2 Block 1 Hyatt Estates Subdivision
The percolation test performed on your sewer system
passed the ade~lacy test.
This department can give f~nal approval if monies ere
escrowed to upgrade the semi-pUblic well.
TO upgrade the well, you will need to install a day-
light drain from the bottom of the well pit so ~hat
it drains to the out~ide.
The upgrade will need to be ~pleted by June 1, 1978.
If there are any further questions, please contact this
office at 264-4720.
SLncerely,
Robert C. Pratt, R.$.
Sanitarian
RCP/lJh
Alaska Statebank
Mortgage Loan Section
310 ~ast Northern Lights Boulevard
99503
October 21, 1977
tIarold Bradford
% Jerry C. Mc Kee
21-767 A Fig Street
Elmendorf Air Force Base,
Alaska 99506
subject: Lot 2 Block 1 Hyatt Estaees Subdivision
Before this department can approve your request for sewer
and water approval a few items will need to be completed.
(1) A percolation test must be perforated toddete~mine ~%e
adequacy of the existing seepage area. See e/%closed
form.
(2) The ~ell is presently in a pit and the pit must be
filled with imperv~s type soil, so that water can
not stand around the well casing.
If theBrsewer system faile to meet the adequacy test, an
upgrade of the system wiI1 be required,
If the up,=de is necessary a permit must be obtained prior
to any construction begins.
If there are any further questions, please contact this
office at 264-4720.
sincerely,
Robert C. P=a%t, R.S.
Sanitarian
RCP/lJh
cc: Alaska Statebank
310 East Northern Lights Boulevard 99503