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Home My WebLink AboutELMRICH VILLAS #4 Block 5 Lot 5 Public Information GAAB-HD-I GRF.~TER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION ~.-~¢~, ~'/ ¢'4-~ /F~ SEPTIC TANK: LIQUID CAPACITY 4 ~'~-~) GALLONS. MATERIAL INSIDE LENGTH MAILINGADDRESS/'-~,'~'/~lJ ~ -~ i~ ~.~'~ °~ 7~/~ PHONE N INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER L,N,NO MATER,A, NEAREST LOT LINE ¢'~Z~)~/ ."~'~" TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL , FOUNDATION , NEAREST LOT LINE , OF LINES ? NUMBERf,O,,I~ LINES D!~T~ LINES ~.,,,,,,¢~¢~H WID~TIVE DEPTH: TOP OF TILE fO F/,INISH GR~E WELL: TYp~/~/~.- .-- -, DEPTH NEAREST LOT LINE ~¢/~Z' . SEWER LINE DEPTH OF FILTER MATERIAL BENEATH TILE. IN. ABOVE TILE DISTANCE FROM /~,/~.Z- WATER ..//. , BUILDING FOUNDATION, SAMPLE ..,~z'e , NEAREST SEPTIC SEEPAGE OTHER · TANK ~./~-- SYSTEM I~/''~ , CESSPOOl .... . SOURCES .... DISTANCES: / DIAGRAM OF SYSTEM DATE APPROVED GAAB=HD-2 GREATE -'ANCHORAGE AREA " ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 Case No. SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT APPLICATION TO INSTALL: SEPTIC TANK ~-"- , SEEPAGE PIT , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY~ ~ _,~ FINANCED THROUGH i~r~COLAT'.ON-TEST RESULTS Cz/~ ~-i~: ~ ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS , /~/~?~ , PERMIT TO INSTALL A ~'~: ¢")~(- AS DESCRIBED BELOW. SIZE O~,UNIT TO BE SERVEO ~Z-~ SEPTIC TANK SiZE ~, ~' TYPE~Z'~/- SEEPAGE AREA ~'g~U~E ' / DIAGRAM OF SYSTEM H~alth Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. -'7.>, / ~--',~"~ ¢~/"~ / 7 ~ -~ .~. ~ / ~ ~'?~REATER ANCHORAGE AREA BOROUGH'-~I HEALTH DEPARTMENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 CASE Performed For C.W. Jones Date Performed May 12, 1970 · "" ' S~b~n Addition 4 ~irnrl~h V¢iias Legal Description: L°~ O Block o T Pert Ol~%l~h'~{''- ........... This Form Reports So~-T~Log · Depth Feet 2 4 .-- 6 8 10 Soil Characteristics m-ow,{ d ~i~:¥~~ Gray Sandy fine to mediun graveg slightly silty GM Brown Silt (ML) G*~y M~dlum I.u .Coarse -k Sand (SW) ./- Was Ground Water Eh, countered? No If Yes, ~+ ~ What Depth Location Sketch GPoss Time Net Time Depth To H20 Net Drop F~o~osed ' ' Instal.~at~on: Seepage Pit Drain Field Depth Of Inlet ~epB~ To Bottom Of Pit Or Tmench C0blMENTS: Draina area should b~ ~2 ft. per · ' " ~e~.po~-O~ ~sO'~ "~ propO~d' ¢, ,r ~-~o;m ~dW~m~, ,,:~', .... ' .... Tost Performed By:~R... E. Carlisle Data CePtified By: ............ Bate: ' FHA Form 2573 Rev. July 195~ U. S. DEPARTMENT OF H~J$1NG ANQ.~JRBA~ DEVELOPMENT FEDERAL HOUSING ADMINISTRATION HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM Budge! Bureau No. 63-R296.8 INSURING OFFICE Anchorag% Alaska MORTGAGOR OR SPONSOR PTERSON, LARRY W. & 3UTHITH KAY SUlL~IVlS~ON,NN~C ~. w,,as S/D PART I.--TO BE COMPLETED BY FHA MORTGAGEE Matanuska Valley Bauk PROPERTY ADDRESS ~Ol Fern Street SERIAL NO. 9oa: oo: a ,tOOK NO. [ TOTAL NUMBER: BATHS 1 BASEMENT Yes [] No g New installation WATER SUPPLY BY: [] Public system [] Community system SEWAGE DISPOSAL 8% [] Public system [] Community system PART lt.--TO BE COMPLETED BY HEALTH DEPARTMENT Can atgic or ~,,',,,~,~ ~,~&~. bo ,T,~,-'& into additional bedrooms? {If Yes, how manyf) ] Individual No. o BDSMS. GARBAGE DISPOSAL [~ Individual [] Yes :~ No 4EALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the [] State [] County [5~ Local Department of Health that this individual water-supply system ~ is [] is not satisfactory as a domestic water supply for the subject property. It is the opinion of the ~l State [~] County [] Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: '15~] Can be expected to function satisfactorily, and [--] Cannot be expected to function satisfactorily is not likely to create an insanitary condition DATE I SIGNAT"RE/ / J TITLE NOTE: The health aut~rJ~ ehould, complete the appropriate opinion sta~lent above and a~x date, signature and title in the 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 ['-] Not Acceptable Sewage disposal be considered ['-] Acceptable [~ Not Acceptable. I DATE CHIEF ARCHITECT ] DEPUTY FOR CHIEF ARCHITECT SIGNATURE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 257 Rev, July 1958 REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY TREATMENT consists of [] Septic tank. [] Cesspool. S~pt!c Tank: Distance from welL__feet. Material Total liquid capacity, Inside length, feet. inside width, Cesspool: Distance from: Well feet; foundation1 __ Inside diameter, feet. Depth, ~CONDARY TREATMENT consists of [] Tile disposal field. Tile Disposal Field: Distance from: Well, Total length of tile lines,. Trench width, Length of each line Number of compartments gallons. Capacity inlet compartment,__ teet. Liquid depth, ___feet. feet; nearest lot line at [] front, [] side, [] rear, feet. Liquid'capacity __.gallons. Lining material [] S}epage pits. Other .... teet; ioundation, 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, t~et. Depth, Distance from: Well feet; building foundation, Inspection mado by: [] State. gallons. feet. square feet. _inches. Date of inspection feet. Lining material -- feet; nearest lot line at [] front, [] side, [] rear,__ [] County. [] Local Health Authority. Inspected by. 19 (TITILI!) inches. REPORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM l)istance to nearest public water main, --.feet. Size of main, inches. Individual wells [] are [] are not custotnary in neighborhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborh~d [] are [] are not being deveh)ped 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 t¥om: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. Distanco of well from: Building fi~undation, seepage pit, Well construction: 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. 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 o£ 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. feet; ( TITL~ff ) GPO 878 471 :EATER 3NO_iOR)~GE ARE^ 3OROUGH V. E3LTH DEPART,' ~2NT 327 EfGLE STREET 3cNCHORAGE, ALASKA 9.9501 279-2511 DATE PECEIVED ', - ' INSPECT: ;,; //".? : " '5'''/' TINE:. ,/ '//- L..'. REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES FOP,. Approval Request?d, By Address /" Phone ,,. / , ('' /'/ Property Owner (. ,;. ', ;,-/~ , ~ /? ,~ r s. Phone .1' t' /' Legal Description (,-- / ", /'~ / ~ : ' / . / /:' (i" STREET: Type of Facility to be Inspected ~ ,,, · Number of Bedrooms Well Data: ',7 777~ ,':T A. Type %/ . B. Depth C. Size D. Construction E. Bacterial Analysis 6. Sewage Disposal System: Ao Septic Tank (If homemade, show diagram on back) 1. Size //'" 2.Age 3. ~4anufacturer /' · 4. Installer 9, . / ,', ,, ;/. Approval Request for Sew Page Two B. Seepage Pit 1. Size 2. Lining Water Facilities C.. Disposal Field 1. Number of Li 2. Total Length 7. Required Heasurements A. Well to Septic Tank B. Well to Seepage Pit C. Well to Sewer Line D. Well to Property Line E. [Veil to Other Possible Contmnination F. Foundation to Septic Tank G. Foundation to Seepage Pit H. Seepage Pit to Property Line 8. CO~,~NTS: APPROVED APPROVAL VALID FOR ONE YEAR FRON DATE SIGNED. GREATER ANCHORAGE AREA BOROU~ HEALTH DEPARTMENT EDll70