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Home My WebLink AboutEAGLE RIVER HEIGHTS BLK 5 LT 20 ' ,-- --'ER ANCHORAGE AREA BOR" -"-'"~ HEALTH DEPARTMENT 327 t.,,~,.E ST. ANCHORAGE, ALASKA 99501 .z511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: MA.L.NG /'3'O.~ Z/ 6. ~' ~,~.e P.ONE ADDRESS LEGAL DESCRIPTION DISTANCE FROM WELL ~J,/~J-J~, LIQUID CAPACITY / ~-'~ GALLONS. 5~""~----"~ ~"' NUMBER OF MATERIAL COMPARTMENTS / ~.,~..r~-~¥..~ /~'.~/L~ g,~, LIQUID INSIDE LENGTH INSIDE WIDTH DEPTH SEEPAGE SYSTEM: NUMBER OF PITS u NINC- MATERIAL NEAREST LOT LINE ~x~'/' SEEPAGE PIT: OUTSIDE DIAMETER ~ OR WIDTH. // ~' / / '~ / LENGTH , DEPTH D,STANCEFROMWEL'- r ' , /--/',.0. - BU,'.DING FOUNDAT'ON SQ. FT. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA FOUNDATION //~,,~*~T LOT LINE DISTANCE BE~ TRENCH WIDTH LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE WELL: TYPE J.,,/l'"'/'~' L,.~.,.-' -D(~. glr_.PlH /'l/,.t..O DISTANCE FROM ~ --J/~/J/J/J/"'J~J?'~' --.,..~, BUILDING FOUNDATION. NEAREST SEPTIC SEEPAGE LOT LiNE ~),'/~ , SEWER LINE 't~,j~'' ,TANK ~:~/~" , SYSTEM TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WATER ~ NEAREST SAMPLE OTHER , CESSPOOL ~. SOURCES DISTANCES: DIAGRAM OF YSTEM DATE APPROVED .~-HD-2 GREATEI.-~NCHORAGE AREA ~ tROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT Case N o. -- NAME OF APPLICANT ~SC)CI,~7-1~I~ t~'LD~'MAILINGADDRESS ~X l(. ~,~, PHONENO. RESIDENCE ADDRESS ~ ~~OM LOCATION OF INSTALLATION /~'~ LEGAL DESCRIPTION ~7 ~0 i ~ ~, ~1" ~ ~ ~/~ ~' APPLICATION TO INSTALL: SEPTIC TANK ~ , SEEPAGE PIT ~ , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY 3 ~, FINANCED THROUGH TO BE INSTALLED BY PERCOLATION TEST RESULTS ~0 ~1~~ ANTICIPATED DATE OF COMPLETION mow To .~ ,~. ou~ ~ .m~. AS DESCRIBED BELOW. SIZE OF UNIT TO RE SERVED . SEPTIC TANK SIZE l~OO TYPE ~ SEEPAGE AREA I''~''-t ~}7"/TYPE DIAGRAM OF SYSTEM DISTANCES: //~ Health Au-thor.t¥ 7 ' I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance N.o. 28-68 and that the above described system is in accordance with said code. ' / / FHA Form U. S. DEPARTMENT OF HOUSING AND UROAN DEVELOPMENT FEDERAL HOUSING ADMINISTRATION HEALIH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DI$POSAL SYSTEM Fecm A~f~oved ~udget Bureau No. 63-R296.8 PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. MORTGAGOR OR SPONSOR SUBDIVISION NAME TOTAL NUMBER: I BASEMENT / PROPERTY ADDRESS hUI~; Col6vilie ~t EaDle ~_v~rt ~la~.a OCK NO. LOT NO. [] New installation WATER SUPI~.Y IY, [] Public system [] Community system SEWAGE DISPOSAL [] Public system [] Community system Con a991c o~ other area be mede into oddlflonal bedroomtT (If Yes, how martyr) N Individual o~ SDSM$. GA"~AO! DISPOSAL [] Individ.a [] ¥e5 o PART Fl.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH D~PARTMENT INSPECTOR'S SKETCH It is the opinion of the [] State 1--] County [] Local Department of Health that this individual water-supply system ~] is [] is not satisfactory as a domestic water supply for the subject property. PUBLIC }{fiTER It is the opinion of the [] 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 ~ealth in tho spaces provided./ Use of the abovo grid for Health Dopartment Inspector's sketch as well os uso of tho back of this form is at the option of the hoalth 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 I SIGNATURE ID CH/~F ARCHITECT DDEPUTY FC~ CHIEF ARCHITECT HIALTH AUTHORITY APPROVAL INDIVIDUAl, WATER SUPPLY AND SEWAGE DISPOSAL SYSTIM FHA Form 257~ ~ev. July 1958 REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY T~EATMENT consists of [] Septic tank. [] Cesspool. ~ptl¢ Tank: Distance from well,__ Total liquid capacity, Inside length. Cosaf)ool: Distance from: Well, Inside diameter, feet. Material gallons. Capacity inlet compartment, feet. Inside width feet. Liquid depth, feet. Number of compartments , gallons. feet; foundation, feet; nearest lot line at [] front, [] side, [] rear, feet. Depth feet. Liquid capacity, gallons. Lining material $ICOND&RY I'R[&?~I~ consists of [] Tile disposal field. [] Seepage pits. Other feet; foundation, feet; nearest lot line at [] front, [] side, [] teat, 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. Se~pogo Number of pits .... Outside diameter, feet. Depth. Distance from: Well, Inspection mado by: [] State. feet. square feet. inches. Depth of filter material over tile, feet. Lining material Tile DispoNI Field: Distance from: Well, Total length of tile lines,. Trench width Length of each line inches. __feet; building foundation~ feet; nearest lot line at[] ~ont, [] side, [] rear,__ [] County. [] Local Health Authority. Inspected by 19 (TITLE) Date of inspectiou____ REPORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM Distance to nearest public water main,__ feet. Size of main. inches. Individual wells 1"-[ 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 si,x:: feet wide, .feet deep. Dwelling set back from front property line~ feet. Individual water supply t¥om: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. Dtatanco of well from: Building foundation seepage pit, Weft coaatn~cflon: feet; tile sewer, feet; cesspool. _feet; nearest lot line at [] front, [] side, [] rear,. feet; septic tank, .feet; disposal field, feet; other sources of possible pollution, ~'eet. Diameter, inches. Total depth, .feet. Type of casing, Approximate depth to pumping level of water in well, feet. Approximate yield, Sealed watertight to depth of feet. Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill. Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No. I~mp: [] Shallow well. [] Deep well. Length of drop pipe, feet. Pump capacity, lx)cated 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. Inspected by Date of inspection , 19__ Depth of casing, gallons per minute. gallons per minute. 19 (TITLE I feet, feet; feet.