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Home My WebLink AboutEAGLE RIVER HEIGHTS NORTH BLK 3 LT 3 Gr '~,TER ANCHORAGE AREA BOROI"~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 N? 151 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCATION SEPTIC TANK: MAILING ADDRESS LEGAL DESCRIPTION · . 3, NUMBER OF DISTANCE FROM WELL c("~)//~//~,/ ,z~,.~' MATERIAL :5'~~:-~':~' - COMPARTMENTS LIQUID CAPACITY /~'~]g; GALLONS. INSIDE LENGTH ~INSIDE WIDTH ~ DEPTH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER LINING MATERIAL NEAREST LOT LINE ~ OR WIDTH 2/,~2 / / LENGTH ~'~// / , , DEPTH ~ DISTANCE FROM WELL~"~)Z~,/~./2~' /-//.~2~/~ , BUILDING FOUNDATION~'~"~' /, TOTAL EFFECTIVE ABSORPTION AREA (WALL AREAI ~~-~,~ SQ. FT. TILE DRAIN FIELD: DEPTH: TO/~POF TILE TO FINISH GRADE DEPTH OF F~TILE IN. ABOVE TILE TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE WELL: TYPE ~*d~/~'~, ,-/L'~-"~/~/, DEPTH ~.~.- DISTANCE FROM ,BUILDING FOUNDATION. /SAMPLE WATER ~, NEAREST --~ NEARES~ ~.~--- SEPTIC /- SEEPAGE / ~------~- OTHER LOT LINE '~"~- , SEWER LINE. , TANK , SYSTEM , CESSPOOL , SOURCES__ DISTANCES: DIAGRAM OF SYSTEM HEALIH AUIHORITY GAAB-HD~2 GREATEI 327 Eagle St. ANCHORAGE AREA HEALTH DEPARTMENT Anchorage, Alaska 99501 ~ 9ROUGH 279-2511 Case N o. ~'~ ~' SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT ~/-~'~ ~ :' ~ ,~' RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH ~'/'½//~ MAILING ADDRESS ]..}-~¥ // PHONE NO. LOCATION OF INSTALLATION ~'.~;,t, SEEPAGE PIT ""/'"~ , DRAIN FIELD To ~E ~NSTALLED BY ~--~-/r C PERCOLATION TEST RESULTS f¢¢'W,~'~ B~E~'~,~ ANTICIPATED DATE OF COMPLETION BELO TO FILLED OUT BY HEALTH DEPARTMENT ,OTHER THIS IS TO SERVE AS (~.-,'/~"~/ .... ,PERMIT TO INSTALLA AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED._~ .SEPTICTANKSlZE /~" /,/TYPE ~*,'/ TYPE DISTANCES: HEALTH AUTHORITY OR LICENSED DESIGNER / C'.~-~'} · .~, ~-'}C'~(.' ,~, ~ I certify that I am familiar with the requkements of Greater Anchorage Area Borough Ordnance No. 28-68 and that the above described system is in accordance with said code. DATE '~''' -~ APPLICANTSSIGNATU"E ~/ ~/'~e GREATER ANCHORAGE AREA B GH Department of Environmental QualitY274_4561 3330 "C" Street, Anchorage, Alaska 99503 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: ~;~ 2. Property Owner: ~Of-~- Mailing Address: 3. Legal Description: L ~- ~ ~Jo ~ ~ o~ ~ R~m 4. Location: /_/.<~.~/~¢~ ~c,,~)'? -o ~ o~rc - r~d -- 5. Type of facility to be inspected /~o~ No. of bedrooms 6. Well Data: A. Type 7pc~/~o C. Construction Sewage Disposal System: A. Installed ~-. / C. Septic Tank: 1. D. Seepage Pit: 1. E. Disposal Field: Size Absorption Area Total length of lines B. Depth D. Bacterial Analysis B. Installer 2. Manufacturer 2. Material Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank , Absorption area , Other contamination , Absorption area , Sewer Lines , C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages 3330 GREATER ANCHORAGE AREA BOROUGH ¢~ Department of Environmental Quality 2~ ~' "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: 2. Property Owner: Mailing Address: 3. Name of Buyer: o o CMRO VA ~./ Mailing Address: ~3d Name of Lending Institution: Mailing Address: ~/~ Name of Realtor o~-~gent: Mailing Address: /¢/ ~. FHA CONV Da), Phone ~ ~'~/'- Z ?~//o Da~/ Phone Phone ,,~ 75 -,,;,q~ ~'d'"'~/ /W~ ,,4',,~ ?o 4/'/~PPh o n e Legal Description: Location: 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility No. Bdrms. ~ Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) EQ-037 (1/74) Secur Pacific :... . 319 WEST 5'1 ii. ANChORAGe, ~ ~01 Page 2 of two pages - Re( ~r Approval of Individual S Water Facilities Legal Description Comments Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) FHA Form 2573 Re¥. July 19'58 U. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Form Approved FEDERAL HOUSING ADM!NISTRATION Budget Bureau No. 63.R0296 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA SERIAL NO. INSURING OFFICE Anchorage, Alaska MORTGAGORORSPONSOR Associate Builders SUBDIVISION NAME Eagle River Heights North MORTGAGEE Alaska State Bank JPROPERTY ADDRESS NHN Tonsina Court TOTAL NUMBER: [ BASEMENT [~New installation BLOCK NO. LOT NO. 3 WATER SUPPLY BY: l SYSTEM DESIGNED FOR [] Public system [--] Community system [--] Individual -o. of ,.,,~. o^.^oE D,S,OS^L SEWAGE DISPOSAL BY: [] system [-1 Community system [] nd v dual [] Yes [] No Can attic or oflter area be mode Into additional bedrooms? [] ','es [] No ~'~ Y'" ~ ..... PART fl.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the [---] 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. PUBLIC ~/ATER It is the opinion of the J---Il State [~ County tern with proper maintenance: ~-~Can be expected to function satisfactorily, and is not likely to create an insanitary condition [] Local Department of Health that this individual sewage-disposal sys- --]Cannot be expected to function satisfactorily DATE Dec. SIGNATURE ~ ' t~l ' ~ t TITLE 18, 1970 I ' ~) "' ~%f %/"f't ~ f~f-~-, J ~ Environmental Health Supervisor t I , . ._ _ ~ -~1 ........ NOTE: The health a~horJ~ould complete the appropriate ap nEon statement above and a~x dote, signature and title in ~t spaces provided. Use of the above grid for Health Department Inspector's sketch as well as use of the back of this form is at the option of the heal~ 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 [--1 Not Acceptable Sewage disposal be considered [] Acceptable [--'] Not Acceptable. DATE SIGNATURE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM [] CHIEF ARCHITECT ] DEPUTY FOR CHIEF ARCHITECT FHA Form 2573 Rev July JgS8