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Home My WebLink AboutSUNNY SLOPES LT 3305 0 (~r'C. ATER ANCHORAGE AREA BOR( 'GH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: LIQUID CAPACITY / Z. 5~/2 GALLONS. INSIDE LENC:~R4- NUMBER OF O-- COMPARTMENTS .~' ,7~c~ ~* / LIQUID INR~nF ~,',,'!DTH--- DEPTH SEEPAGE SYSTEM: NUMBER GE PITS LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER r or WIDTH /'~) .LENGTH "~. '~ , DEPTH DISTANCE FROM WELL ~'~;'~'b~.ml J~b/'~'~--~ , BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA} ~ ~ (~ SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM/.~.~ ~"-~ ~ /F GU N D~)~'~~.-/ X~ ~EAREST/__LOT L, N E.E.E.E.~ ~ ~OF LINES V~ OF~ES '~'~DCS,~E BETWEEN LINES '"'"-,~-~.~T~ENCH WIDTH . T NUMBER AB"~RPTION AREA SQ. FT LENGTH OF EACH DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF ~ILTER MATERIAL BENEATH TILE N ABOVE TILE WELL: TYPE ~v'~'r~t J/~u~'~ DEPTFT' NEAREST LOT LINE · SEWER LINE DISTANCE FROM ~^T~ , BUI~ SAMPLER--~-'~'~'~'?~-NE-A.REST SEPTIC SEEPAGE OTHER . IANI~ . S~(STEM ........ =GE~,~POOE- ~-- ~.~ SOURCES DISTANCES: DIAGRAM OF SYSTEM . OAEE APPROVED O^aB-HD-2 Case No./~ ~/ GREAT ' fi, NCHORAGE AREA.¥_ ROUGH '~-' HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT THROUGH ' TO BE INSTALLED BY_ d ;'=----~--¢ .- BELOW T0 BE FILLED OUT BY HEALTH DEPARTMENT ?,~-.~-..~'(~: .,~. ~EPTIC TANK SIZE /,~' 6'~./) ~,¢PE ~"~,~-/~ SEEPAGE AREA ~ TYPE ,,- .... : ' 7' DIAGRAM OF SYSTEM DISTANCES: I certify that I mn amiliar wit~[~ requkements of Greater Anchorage Area Borough Ordnance No. 28-68 and that the above described system is in ao~raance with said code. GREATE;z ANCHORAGE AREA' ,O-iROUGH HEALTH DEPARTMENT / 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT Case No. NAME OF APPLICANT RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK f,SEEPAGE PIT. ~ , DRAIN FIELD TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH ~//A __ BELOW T0 BE FILLED OUT BY HEALTH DEPARTMENT MAILING ADDRESS ,OTHER THIS IS TO SERVE AS ~'/~./,_ ,~ .~_ ,PERMIT TO INSTALL A ~/~/~'~ ~ ~ AS DESCRIBED BELOW. SIZE OF UNIT T~ BE SERVED ~,~'~~ · S~EP51C ~ANK SIZE //~-) TYPE ~ SEEPAGE AREA ~'~7! TYPE DIAGRAM OF SYSTEM DISTANCES: ~ealth 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. -. APPL CANTS SIGNATURE ~-~-~-" DATE ~ ._ . __ __ / DATE DATE DATE INSPECTOR I MUNiCIPALI~ OE MUNICI~TY OF ANCHORAGE D~PT. OF HEALTH & DEPARTMENT O~ALTH A ENVIRONMENTAL PROTECT~iRONMENTAL ~LSt~et-Anchorage, Alaska 99501 OCT t 5 1980 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATE~ AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not be proce~ed. Please allow ten (10) davs for processing. PHONE PROP[ffiTYffiESIDENT{Ifd[ffe~ent ro } PHONE MAILING ADDRESS · ~ PRONE ~AILING ADDRESS / 5. LEGAL DESCRIPTION STREET LOCATION / 6. TYPE OF RESIDENCE / NUMBER OF~BEDROOMS [] One ,J~ Four ,J~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ~ COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** .YEAR ON-SITE SYSTEM WAS INSTALLED. ~ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (.er. 6179, ~(~..~.~ /~ ~ .~-~L~ ~' ~. ~,~ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI L[TY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED E~] PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS E~.-- APPROVED FOR ~"~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79) FHA Farm 2573 U. S. DEPARTMENT OF HOUSING AND URBAN OEVELOPMENT ~ Form Approved HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE · MORT.GAGEE SERIAL NO. Anchorage, Alaska z Natzonal Bank of Alaska 59006gl MORTGAGOR OR SPONSOR PROPERTY ADDRE. SS Sunny Cmrcle; Eagle Ri,~VgCrK~NoA?aska LOT NO. Construction Co.~ LeMa =y SUBDIVISION NAME Sunny Slopes TOTALf NUMSER: ~] BASEMENT 1 4 Yes [] No WATER SUPPLY BY: {~](Public system SEWAGE DISPOSAL BY: F1 Public system ~Community system --]Community system ] New installation additional bedrooms? (If Yes, how manyF) SYSTEM DESIGNED FOR I J Individual ~~ Individual }l [] Yes ~] No PART IL--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 WATER 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 DATE J SI ATURE Sanitarian Jan. 20, 1971 ~ , - NGTE: T Uld complete the appropriate opinion statement above and affix date, signature ~nd title in the Uso of the th Department Inspector's sketch os well as use of the back of this farm is at the option of the 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 Acceptab!e. SIGNATURE ]~ CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT DATE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 REPORT OF INSPECTION~INDIVIDUAL SEWAGE-DISPOSAL SYSTEM Total liquid capacity. Inside length, feet. Material gallons. Capacity inlet compartment, feet. Inside width, feet. Liquid depth,__ feet. Number of compartments .gallons. feet; nearest lot line at [] front, [] side, [] rear, feet. Liquid capacity, .gallons. Lining material [] Seepage pits. Other square feet. inches. inches. feet; foundation, 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, [] Broken stone. Other Depth of filter material beneath tile~ inches. Depth of filter material over tile, Number of pits ..... Outside diameter, feet. Depth, feet. Lining material Distance from: Well .... feet; building foumlation, feet; nearest lot line at [] front, [] side, [] rear, Ins~olon made by: [] State. [] County. [] Local Health Authority. Inspected by. Date of inspe(tion____ 19 REPORT OF INSPECTION~INDIVIDUAL WATER-SUPPLY SYSTEM Distance to nearest public water main,__, feet. Size of main, inches. Individual wells [] are [] are not customary in neighbgrhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborhood [] 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 from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. I)tttance of well from: Building foundation,_ seepage pit, 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,. :feet. Depth of casing, gallons per minute. 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. [] lklddfed 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, la<ated 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 of 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 feet, feet; gallons per minute. feet. 19__ GPO 889'088