HomeMy WebLinkAboutELMRICH VILLAS #4 Block 5 Lot 3 Public Information
GA.AB-HD- I
G~-E. ATER ANCHORAGE AREA BOROJ-IGH
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-251
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
NAME ~J'"'~/~'"J'/'~ ~"~:~-/'~ ADDRESS_.~'=f./~' ~),x.. ~z",cC2~x'~.,~'-j~ PHONE~,~_'~/c:/~'.-~
SEPTIC TANK:
DISTANCE FROM WELL ~/~'~: ~/~'-' ~
LIQUID CAPACITY /~'~ GALLONS.
NUMBER OF /'
MATERIAL ~/~/~':~"'~-~ ,,,'~-,r>'~-~/~ COMPARTMENTS
~ i LIQUID
DEPTH
INSIDE LENGTH 7 INSIDE WIDTH ~
SEEPAGE SYSTEM: SEEPAGE PIT:
/' OR WIDTH /'-~ / /
, LENGTH /--~' , DEPTH
,.- OUTSIDE DIAMETER
NUMBER OF PITS (~ ~//b/~_,_~.~)
NEAREST LOT LINE C-~2c~ / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) z~'~"~<~ ~ SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL -- , FOUNDATION , NEAREST LOT LINE. OF LINES
DEPTHS: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE__
WELL: TYPE~,x~/~/-~} DEPTH ,/ DISTANCE FROM ~ WATER /t/~) NEAREST
. , , BUILDING FOUNDATION. SAMPLE
NEARES] , _~..~8'EPTI C ..SEEPAGE ~..~-~- OTHER
/~/ , SEWER LINE ~ ~TANK ~ SYSTEM ~, ~SSPO0£ SOURCES
LOT LINE :
DISTANCES:
DIAGRAM OF SYSTEM
HEALTH AUTHORITY
GAAB-HD-2
GREATEF-'ANCHORAGE AREA--'DROUGH
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
Case No. ~/~
LEGAL DESCRIPTION ,~-~?- 3) ~)~-~'-,.~-
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
F INA_N~CED THROUGH ~- ~-~Z_ /-~
~N TEST RESULTS
C"'~' ., SEEPAGE PIT
, DRAIN FIELD , OTHER
TO BE INSTALLED BY
ANTICIPATED DATE OF COMPLETION ,,'~/'- J/"~
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS - '--'4'~ ~,,'f~ , PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO 'BE SERVED
HEALTH AUTHORITY
OR
certify that I am familiar with the requirements
of Greater Anchor,age Area Borough Ordinance No. 28-68 and that the
b°vedesclib:stem/inacc°rdancewithsaidc°de' ~d?-U/q~-/,O d/F'Z~'Y ~/,,
/ ~, / ,-.- _ _~_
,RATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT CASE
3~7 EAGLE STREET
ANCHORAGE, ALASKA 99501
~k'ock~ S~di~is~ : m~,~ ~,%~ ....
Depth
Feet
.Was G~ound WateP Encountened?, ~c,;~ ,, ~F~l
if Yes~ At What Depth__ '
Location Sketch
, Readi?g Date GPoss Time Net Time Dept~ To H20 Net Drop
ePc6iation :ate 1'"/' · 'Man,,*~ ............I
Fm,oposed Instali'~tion:~ Seepage Pit : Dz'ain Field
Depth Of Inlet , Depthi.T'o BOttom"O~'~pit Ox~ TPench'"
Data Certified By:_ A!ask~.Geo!ogiga~ Consultants
ate ~ .i ~ 970
'~J'L~ ~'~x~ . ~ U. $. DEPARTMENT OFIIOUSINGANDURSANDEVELOPMEN~J' . Form App,ov~,J'
Ai~cho~'age Ils'i: Federal Savings & Loan Il ]ii-014204
ELHRICI{ VILLAS / 5' /
..... ~
i?;J is [7~ is not satisfactory as a domestic water supply for the sul;jcct property. C.A, []. 14/a'i;ar
t:m with propee mainte.ance:
~ ~ be expected t(~ function satisfactorily, and
;~:~O~:l~k~l~ to create an insanita~ condition
O/ ~
L~. Cannot be expected to function satisfactorily
¥1¥LE
l[{llvil'oJiifl()n'~,al SI-recial ist
kava rc.ei;::,/ed the foregoing aid the pcctimtnt FtlA Coml>lJancc Inspection Rej,oit, and lccommend tlmt
DEPARTMENT- OF ENV'IRONNENTAL
3500 TUDOR
ANCHORAGE,' ALASKA 99507
'27'9-8686
REQUEST-FOR'APPROVAL OF' .
INDIVIDUAL SEWER AND WATER. FACI'LITIES
FOR
1. APPROVAL REQUESTED BY:
ADDRE'SS~ 30 S ~' ~¢---*
PHONE: . 2.7~- ~r./~/_ '." ;' ' -".,.~.
Z. PROPERTY OWNER: ?E.r'P£. ~, I'~,~C:~ PHONE:
3. LEGAL DESCRIPTION:
4. TYPE FACILITY TO BE INSPE
NUMBER OF BEDROOMS: ~ ·
5. WELL DATA: PA~/-] /z~/~z/~'¢~'
A. TYPE
B. DEPTH
C. SIZE
D; -CONSTRUCTION
E. BACTERIAL ANALYSIS
6. SEWAGE DISPOSAL SYSTEM:
A. S'EPTIC'TANK (IF HOMEMADE, SHOW DIA6RAM ON.BACK)
1. SiZE /¢ ,
' - PR VAL RE UEST FOR-SEWER
~ AP. O~ Q
SEEPAGE P~T
2, LINtNG~
7. REQUIRED MEASUREMENTS '
A, WELL TO SEPTIC TANK ~ -.~;"~
B, WELL TO SEEPAGE PIT ~\ · '...
C. WELL 'TO SEWER .LINE ~ , ·
D, WELL TO'PROPERTY LINE ~ ~ · ' . "i i; .?i']..!:
E. WELL TO OTHER POSSIBLE :CO.NT~INATION
F. FOU,D'ATION TO SEPTIC TANK
G. FOUNDATION TO SEEPAGE PIT. ~0 /
H. SEEPAGE PIT ZO PROPERTY LINE "2...~. ~ -~ .
8. COMMENTS:
APPROVED: -DISAPPROVED:
DATE DATE:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BO.ROUGH DEPARTME