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Home My WebLink AboutEAGLE RIVER HEIGHTS BLK 5 LT 19050 C~r 'TER ANCHORAGE AREA BORC H ,._ HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING LOCATION ~'~, ,/~'~, .//~.~--'~/' -~-~'~' ...B'" LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY J'/~) ~/~ GALLONS. NUMBER OF MATERIAL ~ ..,.,.~,~ ~--.~.,..~,~_r-,~_ COMPARTMENTS ,,,e,~.77 o... _~ 7"-.zz.:~.z., /'/~ INSIDE LENGTH. INSIDE WIDTH LiQUiD DEPTH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER LINING MATERIAL ~ ~ ~ NEAREST LOT LINE '~'"~"~ / OR WIDTH / ,'~ / /~- / , LENGTH . , DEPTH DISTANCE FROM WELL ~-'~,~:-)~/~ · . BUILDING FOUNDATION__ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ,~'~ sq. FT. TILE DRAIN FIELD: DISTANCE FROM WELL ~ ~...~"~"'""~, F UNDATION ~, ~¢~AREST LOT LINE NUMBER OF LINES ,-'~'"~"~' DISTA~ )~ ABSORPTc~AR~A SQ. FT. LENGTH OF EACH LINE TOTAL LENGTH , OF LINES ., IN. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE /~.---',g ~/ DISTANCE FROM WATER WELL: TYPE ~'~/~,~ , DEPTH , BUILDING FOUNDATION. -- ' SAMPLE NEAREST SEPTIC SEEPAGE LOT LINE '----"'" , SEWER LINE "-'-'-- , TANK --'"'-- , SYSTEM , CESSPOOL DIAGRAM OF SYSTEM DISTANCES: , NEAREST OTHER · SOURCES__ H EALTh~A UTHORITY ¢ 7 Petition Data $ $ Form Approved FHA Form 2573 . FEDERAL HOUSING ADMINISTRATION Budget Bureau No. 63-R296.8 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. Anchorage, Alaska Alaska State Bar~ 111-010873-203 MORTGAGOR OR SPONSOR PROPERTY ADDRESS Colville Street Associate Buil~ersz Inc. ~UBDIVISION NAME I BLOCK NO, LOT NO. Eagle P~tver Heights Subdivision 5 19 TOTAL NUMBER: Can attic or other area be made into ~ New installation additional bedrooms? BASEMENT LIVING UNITS SEIDROOMS BATHS (If Yes, how man¥~) Z 3 Z r-]Yes ~ No r-]Yes ~No WATER SUPPLY BY: SYSTEM DESIGNED FOR ~ Public system [] Community system [--] Individual No. OF ,U,MS. ~^.,^o~ D,S.OS^L SEWAGE DISPOSAL BY: [] Public system [~1 Community system ~ Individual ['-1 Yes [] No PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT 4EALTH DEPARTMENT INSPECTOR'S SKETCH __-__-!!: .................................... ..... ZZZZZZZZZZZZZZZZZZZZ~ZZZ ZZZZ_'ZZZZ~ __ZZ_ZZZZZZZZZZZZZZZ~ZZZZSZZZZ: ZZZZZ ZZZZ- ZZZZ; ~7_7_7_ZZZZZZZZ_-ZZZZZZZZZZZZZZZZZZ ZZZZZ --:-: ............. - ...... -ZEEI It is the opinion of the FI State [] County [] Local Department of HealEh that this individual water-supply system [] is [] is not satisfactory as a domestic water supply for the subject property. PUBLIC WATER It is the opinion of the J~l State [] County [] Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: ~1 Can be expected to function satisfactorily, and [] Cannot be expected to function satisfactorily is not likely to create an insanitary condition DATE SIGNATURE//~/'~// ~, / ~//'. //~.. ~/ ~~:.// TITLE Aug. 17, 1970 .-~ ~::)'~.~r.~-,~,~,~ Environmental Health Supervisor NOTE: The healCau~ity should complete the appropriate opinion statement above and affix date, signature and title in the spaces provided. Use of the above grid for Health Department Inspector's sketch as well os use of the back of this form is at the option of the health authority. PART Ill.--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. DATE SIGNATURE [] CHIEF ARCHITECT ] DEPUTY FOR CHIEF ARCHITECT HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July I 958 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, .feet. Inside width, feet. Liquid depth, .feet. feet; foundation, feet. Depth, SECONDARY TREATMENT consists of [] Tile disposal field. [] Seepage pits. Other Tile Disposal Field: Distance from: Well, Total length of tile lines,. Trench width Length of each line gallons. feet; nearest lot line at [] front, [] side, [] rear, .feet. Liquid capacity, .gallons. Lining material .feet. Lining material __ feet; nearest lot line at [] front, [] side, [] rear, [] County. [] Local Health Authority. Inspected by- 19_ (T~TLe) feet. square ~et. inches. feet; foundation, feet; nearest lot line at [] front, [] side, [] rear,. feet. Number of lines, Distance between lines, inches. Total effective absorption area in bottom of trenches .feet. Depth, top of tile to finish grade, Type of filter material: [] Gravel. [] Broken stone. Other_ Depth of filter material beneath tile,, inches. Depth of filter material over tile. Number of pits . Outside diameter, feet. Depth, Distance from: Well, feet; building foundation, Inspection made by: [] State. inches. Date of inspection REPORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM Distance to nearest public water main, feet. Size of main, inches. Individual wells [] are [] are not customary in neighborhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborhood [] are [] are not being developed with both individual water-supply and sewage-disposal systems. Lot size: feet wide, feet deep. Dwelling set back from front property line,, feet. Individual water supply from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. Distance of well from: Building foundation cast iron sewer, feet; tile sewer,. seepage pit, feet; cesspool, Well construction: Diameter, inches. Total depth, Approximate depth to pumping level of water in well, Sealed watertight to depth of feet. feet; nearest lot line at [] front, [] side, [] rear, .feet; septic tank, feet; disposal field, feet; other sources of possible pollution, .feet. feet. Type of casing, Depth of casing, .feet. Approximate yield, .gallons per minute. Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill. Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No. Pump: [] Shallow well. [] Deep well. Length of drop pipe, feet. Pump capacity, Located in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit. Pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No. Type of storage: [] Pressure. [] Gravity. Capacity, .gallons. Has bacteriological examination of water been made? [] Yes. [] No. If answer is "yes," give date Quality of water [] is [] is not satisfactory for human consumption. Installation [] does [] does not comply with approved exhibits, if any. Inspection made by: [] State. [] County. [] Local Health Authority. .gallons per minute. Inspected by Date of inspection 19 19 Ffl~ No.: 4-1 15 Colvflle Str~K It hmo been brought to o~ stteuti~ that publl~ sewer is av&tisble to Lot lO, Block S, Eagle River l~elg~ts Subdivision. A~g to the AnehoFege Crab of OFdinm Chapter le, "Sept~ tmk-~ system seuqe disposd halli~ shell not sam ps. ribes...". The Munk4pdity or ~ Depm. tment or I'ubll, Works bas checked their ~ md they lndte~te thM yem. stmatm.~(s) is not connected to the smfltm, y Mwer. WouM you please eheek your reeords to veFlfy that the st~ueture (.) fs or is not oonnGetod and ~lotffy ~ lmm~d~tely if your reoordo tndieMe thM · c~e~c~Ao~ hss been mede. Ir we do not heu* from you witldn seven (?) drys. we wtll eosume that our re~ordo m.e om. Feat. We. the~tfore. Fequ~ot ~ ~mne~t any edtd dl ~ ~ on b subJcet progert7 to pulflie cewer by You ~ust ~ roF & ~ permit f~om the pomtt officer for the ~unlMp~i_t_~ty of AnehoFage, 3SOO Bast Tudm* P~d. if you hive Shy qucetimu ~gsrding the 8bo~, please do not hesitate to eoltta~t the permit officer at ~8SM, e~teusfon SS~ or th~ Depm~tment of Health md P~t~ at LB/Iw RECEIPT FOR CERTIFIED MAILm30~ (plus postage) SENT TO POSTMARK OR DATE STREET AND NO. P.O., STATE AND ZiP CODE OPTIONAL SERVICES FOR ADDITIONAL FEES RETURN Ilk 1. Shows to whom and date delivered ........... 15¢ With delivery to addressee oniy ............ 65¢ RECEIPT p 2. Shows to whom, date and where delivered .. SERVICES With delivery to addressee o~iy~, ........... OELIVER TO ADDRESSEE ONLY ..................................................... SPECIA~L DELIVERY (extra fee required) .................................... PS Fern NO INSURANCE COVERAGE PROVIDEO-- (See other A~. Z97! 3800 NOT FOR INTERNATIONAL MAIL ~o:~g?~ o-~e0-?~g