HomeMy WebLinkAboutSUNNY SLOPES LT 13
GAAB-HD I
HEALTH DEPARTMENT , , -~JV/':(9'~J~'~,~: ~;
327 EAGLE ST. ANCHORAGE, ALASKA 99501 2/9-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
NAME /--~L~/'~/ ~¢-~'~/~'2'/~"~ ADDRESS d:;~7~. ~, ~ ~- PHONE -
LOCATION ~~ ~/~ ~,~. LEGAL DESCRIPTION ~T
- ., /~ ~-~
SEPTIC TANK:
DISTANCE FROM WELL~"~',,-'~,',/~/../~/'.,~ ~]
LIQUID CAPACITY /~Z2 ~:~ ~ GALLONS.
MATERIAL --5~'--'--~-/~'-~,~'~ NUMBER OF
COMPARTMENTS
INSIDE LENGTH / INSIDE WIDTH ~.~-- LIQUID
DEPTH_
SEEPAGE SYSTEM: SEEPAGE PIT: ..4'O/,z~ ~ z.,,/~.,.,/~.4~-- .,~'~,.,.~. ,,~,~,r.-/.~..,:,Z- .,~'~.,,,~g~-./~'.
NUMBER OF PITS
LINING MATERIAL~
NEAREST LOT LINE
OUTSIDE DIAMETER ~
_OR WIDTH_ /r"~* / , LENGTH /'.~ /, DEPTH. ~/
DISTANCE FROM WELL ~~ . BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ .SQ. FT.'~
TILE DRAIN FIELD:
~f F~A
DISTANCE FROM WELL~, / TION
DISTANCE BETW EN LINES
ABSO TION AREA SQ. F OF
/~ TOTA_ LENGTh
NEAREST LOT LI ~ OF LINES
IN. T 0 T A L,~=~--~'i~V E
EACH L
DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: TYPE ~'":g'"J'~/~', ~ .~ DEPTH /
LOT LINE / NEAREST / SEPTIC
., SEWER LINE , TANK
DISTANCE FROM WATER
· BUILD NG FOUNDATIOI~ / · SAMPLE_ .'':1/~ , NEAREST
/ SEEPAGE / OTHER
· SYSTEM , CESSPOOL z~------. SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
HEALTH AUTHORITY
GAAB-HD-2
GREATEI~ j~.NCHORAGE AREA '~_~I~0JUGH/~' case No,
.... HEALTH DEPARTMENT ~ "~/~'~ .~ ? ~ ~,,
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT~ '
BEIO~ TO BE FmllED OUT BY HEALTH DEPARTMENT
THIS.,IS TO SERVE AS
,,AS DESCRIBED BELOW· SIZE OF UNIT TO BE SERVEO ~"
· SEPTIC TANK SIZE /~ TYPE ~ E REA/~
, SEEPAG A
' .~" DIAGRA~ OF SYSTE~--
DISTANCES: I ;'
I certify that I am familiar with the requirements of Greater Anchorage Area,Borough Ordinance No. 28-68 and that th
above described system is in accordance with said code. /r~t~,~-~2:~L~t.~
FHA Form 2S73
Rev. July 1,958
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART L--TO BE COMPLETED BY FHA
X~XX~
INSURING OFFICE
Anchorage, Alaska
MORTGAGEE
Matanuska Valley Bank
MORTGAGOR OR SPONSOR
Straub Builders
SUED'~i~i;A~E1op es
BASEMENT
New installation
2 [--]Yes [-"]No
W&~IR SUPPLY BY:
[~ Public system [] Community system
SEWAGE DISPOS&L
[] Public system [] Community system
PART II.~TO BE COMPLETED BY HEALTH DEPARTMENT
PROPERTY ADDRESS
NHN, Sunny Circle
ELOCL._O_ LOT
additional bedrooms?
(If Yes, how many~)
SYSTEM DESIGNED EOR
II Individual I
~[] Individual ' ' [] Yes [] No
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 I~/ATER
It is the opinion of the [] State [] County [] Local Department of Health that this individual sewage-disposal sys-
tem with proper maintenance:
[] Can be expected to function satisfactorily, and [] Cannot be expected to function satisfactorily
is not likely to create an insanitary condition
NOTE: The hnal~t, th~ should comglete the appropriate opm on statemnnt above and ~ffix dote, signature mhd title In the
spaces provided.
Uso 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
DATE SIGNATURE
Individual water-supply system be considered [] Acceptable [] Not Acceptable
Sewage disposal be considered [] Acceptable [] Not Acceptable.
] CHIEF ARCHITECT
] DEPUTY FOR CHIEF ARCHITECT
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
FHA Form ~,~
Rev. July 1958