HomeMy WebLinkAboutO'BRIEN BLK 6 LT 9 ZION COURT PH1 GE 'ER ANCHORAGE AREA BOROL
DEPARTMENT OF ENVIRONMENTAL QUALITY.
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
D STANCE E OM WELL__
LIQUID CAPACITY ,/'(-',¢..~(D
GALLONS.
MATERIAL
ADDRESS
NUMBER OF -.)
~-~':'~Z/ COMPARTMENTS_ ¢
INSIDE LENGTH INSIDE WIDTH. DEPTH
SEEPAGE SYSTEM: SEEPAGE PI1:
NUMBER OF PITS__ I OUTSIDE DIAMETER
NEAREST LOT LINE_ 6
OR WIDTH__~ '/ . LENGTH__] '7 , DEPTH
DISTANCE FROM WELL -K".-'= I
., BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL ~_'~ '~ , FOUNDATION~"~-"'--~ , NEAREST LOT LINE
~"~'""~ WIDTH
NUMBER OF DISTANCE BETWEEN LINES .~:NCH
ABSORPTIQ~g AREA ~__ SQ. FT. LENGTH OF EACH LINE ~
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
OF LINES
IN. TOTAL .~FFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE__ ____IN. ABOVE TILE____
WELL: TYPE ~Dei I(~'s'J') ., DEPTH.
NEAREST -
LOT LINE , SEWER LINE
./r DISTANCE FROM ¢(R/¢. -- WATER
, BUILDING FOUNDATION../_¢_
SEPTIC -~
TANK ~ / ~* SEEPAGE ,.
.... SYSTEM. ~i , CESSPOOt
, NEAREST
OTHER
. SOURCES
DIAGRAM OF SYSTEM
DISIANCES:
GREAiER ANCHORAGE: AREA BORuUGH
DEPARTMENT OF' ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-050
ANCHORAGE. ALASKA 99502
TELEPHOC4E 279-8686
PERMITNO. / /~/¢¢)O/
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
(-~'-1 '~ "W' "~ q'
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT /'i/ DRAIN FIELD , OTHER
. L).L: ,:' ~ ~{~ "NOTE: ~IS PERMIT IS NOT VALID WITHOUT SOIL TE~T
FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSEI~UTION.
: ,- :.- ,.-, .-.,,,,' C-., / ',/? ,/, /
DIAGRAM OF SYSTEM
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK ~
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE Pit WALL '
SEPTIC TANK , SEEPAGE PIT
TO NEAREST LOT LINE.
DRAIN FIELD
WATER MAIN TO SEPTIC TANK //_:"L
DRAIN FIELD
SEPTIC TANK, ¢" --~-~ t , SEEPAGE Pit
TO RIVER, LAKE, STREAM.
, BRAIN FIELD
· DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
· SEEPAGE PIT
DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON P]PES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION·
HEALTH AUTHORITY
/ ./ LICENSED DESIGNER
I CERTIFY THAT ] AM FAMILIAR WITH THE REQUIREMENTS OF GREATER AN~OR~E AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCB[BEJ:), SYSTEM IS IN ACCORDANCE WITH SAID CODE. ~/ / j~ /] ~
Git" "ER ANCHORAGE Ai<EA BOROUGh,
DEPAh. ,ENT SF Ei~'IR,q~qF~':"NL F:.'JAi ~
3500 TUDOR ROAD
ANCHORAGE, /~LASKA 99502
CASE
Performed For Dick Banner & Sons Date Performed 9/16/71
Legal Descrip~-Ton: LOt..~6'?Block~.9-~rSubdivision O'Srien
This Form Reports Soils Log × Percolation ~rest
Depth
Feet
Soil Characteristics
Gray & brown ~ravelly silt
Gray silty sandy gravel (GM)
and gray sandy gravel (GW)
layered and seamed
6~
no
Was Ground Water Encountered?
If Yes, At What Depth?
o
Reading
Date
Gross Time ~ Net Time ! Depth to ii20
Net Dro~
IA Form 2573
F[DERAL HOUSING ADMINISTRATION Budget Bureau No, 63.R0296
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I.~TO BE COMPLETED GY FHA
iNSURINg OFFICE
Fedcr~]. ,~&)u~ing A~nis~z'a~:ion
MOR'rOAGOR OR SPONSOR
O'BRI~, Komteth
SUBDIVISION NAME
MORTQAOEE SERIAL NO.
Me,emus, ha !/siley B~¢ ].I].--
IROPERTY ADDRESS
'?4th a~d I~ke O'bi~ Road, Ancho~age, A:Laska
BLOCK NO. LOT NO.
TOTAL NUMBER~
.l 3
WATER SUPPLY ~Y:
[~] Public system
SEWAGE DISPOSAL BY:
Can attic or other area be made Into
BASEMENT ~ New installation addltJanal bedrooms?
(If Yes, how many,]
¥es ¥es
]1 SYSTK~ DESIGNED FO~
~ ~mmuniW system No. al SDRMS. GARBAGE DISPOSAL
~ ~mmunity syscom ~ Individual [3 ~ Yes g No
[~]Public system
PART II,~TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
It is the opinion or the [] State [] County N Local Department of Health that this individual water-supply system
J~] is [] is not satisfactory as a domestic water supply for the subject property.
It is the opinion of the [] State [] County
tern with proper maintenance:
~] Can be expected to function satisfactorily, and
is not likely to create an insanitary condition
] Local Department of Health that this individual, sewage-disposal sys-
]Cannot be expected to function satisfactorily
~ATE
,]an,
t SIGNATURE . J TITLE
21, 197 / , Envtronl?ental Specialist
NOTE: The health authority should complote the appropriate opinion statement abovo and ol~x date, signature ~nd titlo iii tho
spaces provided.
Uso of tho above grid for Hoalth Department Inspector's sketch as well as use of tho back of this form is at the option of the
health authority,
PART III.~FOR US[ OF FHA OFFICE
TO YI'IE 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.
DATE
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATI~R SUPPLY AND SEWAGE DISPOSAL SYSTEM
] CHIEF ARCHITECT
] DEPUTY FOR CHIEF ARCHITECT
FHA Form 2573
Rev. July 19,50
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
TIME:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER AND WATER FACILITIES
FOR
ADDRESS: x.~ .
PHONE: ~ ~ ~ - ~ 7 C~
2. PROPERTY OWNER: ..,/~--~-n- ....
4. TYPE FACILITY TO BE INSPECTED:
NUHBER OF BEDROOMS: ~' ~'~
5. ~ELL DATA:
A. TYPE
C. SIZE ~ m
CONSTRUCT ON
E. BACTERIAL ANALYSIS ---a?//~.~F'~
6. SEWAGE DISPOSAL SYSTEM:
PHONE:
2. AGE'
3. MANUFACTURER
4 INSTALLER ~,~,
%
APPROVAL REQUEST FOR SEWER & WATER FACILITIES
PAGE TWO
B. SEEPAGE PIT
2. L I N I N G ~f.x~c
C. DISPO~L FIELD
1. NUMBER OF LINES
2. TOTALXLENGTH
REQUIRED MEASUREMENTS
A. WELL TO SEPTIC TANK
B. WELL TO SEEPAGE PIT
C. WELL TO SEWER LINE
D. WELL TO PROPERTY LINE //~~'~JF~
E. WELL TO OTHER POSSIBLE CONTAMINATION
F. FOUNDATION TO SEPTIC TANK ~
G. FOUNDATION TO SEEPAGE PIT ~'~
H. SEEPAGE PIT 1'0 PROPERTY LINE ~ ~
COMMENTS:
DATE :_~ ?'~--~ DATE:
APPROVAL V/~LID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALI~
Suhi~¢t: [o',; r~. n]oC~ .~i~ O'Brien SubdJvJston,
[:0 ur~(?rn,Jr, t'i~c w~tl and fill in the old sr:,ver