HomeMy WebLinkAboutALMA LT 3
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES
(Fill out in Triplicate)
~, 1,la~ .of person requesting approval ~\F~_ ~/, P~k~v'f.~_J
2. ~ta~. of property-, owner
~. NumLez. ~¢ bedrooms in house .
5.
Water, Analysis:
a. Bacterial
b. Detergent
Well data:
Type .... ~
b. Depth
c. Casing Size
Distance from well to closest existing or proposed:
1. Sewep line
2. Septic tank
3. Seepage Area
Cesspool:
5. Property Line
6.
Other sources of possible contamination, i.e.~ creeks~ laj~es~
houses, barn, drainage ditch~ etc.
Sewage disposal system.
a. Age of system
b. Septic tank capacity in gallons .
c. Name of septic tank manufactumer
1. If "home made" show diagram on reverse side of this form.
d.' Disposal field or seepage pit size and type
Distance to property line to house foundation .
e. Percclation..Te'st~r~sults
f. Percolation Test performed by
Use the reverse.side of this form to show diagram. Diagram should include
"~he foil.owing information: p~operty lines ; .well location, house location,
~t~c tank location, disposal area location, location of percolation test,
a~ direction of ground slope.
9. The i~-fo~,,~mt]on on this form is true and correct to the best of my knowledge.
S,ignature of Applicant
Date Signed
TO BE FILLED OUT BY HEALTH DEPARTS.lENT PERSONNEL
above described sanitary facilities are hereby approved, subject to the
~6'l!owing cond~io~ts:
Conditions:
~The above described sanitary facilities are disapproved ~owing
reasons:
~Date . .: . .
Approval is valid for one year following the date of approval.
CPJ:cw
April 25, 1969
Mr. a~d Mrs. ~;eaver
228 Patterson '
Anchorage, Ala.~ka g950~
SUBJECT: Semi-Public Well Serving
Five ~o~es Located on You~ P~operty
Lot 3, A]Jaa Subdivision
Dear Mr. and M~. Weavers
Personnel of the Greater Anchorage Area Borough Health Department have
made a z~cent inspoction of <he subject wate~ supply. At ~he Lime
of the inspection it was no, ed <hat three cesap~ls were in existence
which were all within the 150 ft. ~,adius Pe'tu~r~d on a seml-puJDlic well.
In order for the well to be approved b~ this Depart~;:en~, ~d ~herefo~
continue sez, ving mo~ than o~:e ~sidence, certain cor~ctions of
sewage system and the well ~e necessa~. ~'hese commections c~stttu~e
~he installation of septic tanks of required size on line in your sewage
~ystem, also the sewage system of ~P. Sauer ~d Mr. J. T. Burton.
Pea!ts fop the i~stallali~ of septic t~ks may be obtained at This
office.
Well correction consists of extendinZ the casin~ ~e inch above ground
~]d filing in the existin~ pit w~th soil. This can be accomplished
with the installatl~ of a pitless adapter.
Enclosed you will also find easement papers (one example) which should
be filled out, si~ned and ~corded at tb~ ~tate Recorder's offi~.
They ins~e ~hat in ~he fu~u~ mo one will violate yo~ well radius
~ce ~he well is app~ved. ~eV must be si~ned by all peopleaw~h any
pa~ of ~he~r propeP~Y within 120 feet of yo~ well.
~is office will ~guest tha~ ~P. burt~ and Mr. Saue~ install
~anks tn line w~th ~heir sewage systems.
No,al pr~edure in such eases would allow Mr. Sauer and ~4~. Burton ~5
days ~o install septic ~anks. Since you a~ the well owner, we will
all~ three weeks for yo~ septic tank ~o ~ installed and well ~o be
Page 2
April 25, 1969
Since easement papers frequently involve contaoting and getting
signatures from # to 5 families, we will allow from 6 to 7 weeks for
this to be accomplished.
Please feel free to contact this office if you have any questions
re~amdin8 these matters.
$ in cere ly,
DAVID R. L. Db~CAN, M. D.
:-~edicai D~rector
BY=
Davi'd ~. Harkness, ~. S:-
Sanitarian
DBH/sr~