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Home My WebLink AboutRAYMOND TEDROW BLK 3 LT 21A (2).0 0 -'/5-4 -zt- 0 -0o o G,~:ATER ANCHORAGE AREA BORO~'~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /"~6~ LOCATION SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY GALLONS. MATERIAL ~c ~'~''~: Z NUMBER OF COMPARTMENTS SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL__ NEARESI' LOT LINE SEEPAGE PIT: / OUTSIDE DIAMETER OR WIDTH. /,~ D,STANCE EROM WELL__ / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ,LENGTH /2 ,DEPTH BUILDING FOUNDATION__ TILE DRAIN FIELD: DISTANCE FROM WELL FOUNDATION , NEAREST LOT LINE__ NUMBER OF LINES DISTANCE BETWEEN LINES_ TRENCH WIDTH ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MA'rERIAL BENEATH TILT WELL: ~ ~'~ISTANCE FROM WATER TYPE DEPTH. ,BUILDING FOUNDATION. SAMPLE. NEAREST SEPTIC SEEPAGE LOT LINE ., SEWER LINE. , TANK , SYSTEM , CESSPOOL TOTAL LENGTH OF LINES IN. TOTAL EFpECTIVE IN. ABOVE TILE__ , NEAREST OTHER , SOURCES__ DIAGRAM OF SYSTEM DISTANCES: GAAB-HD-2 GREATEi 327 Eagle St. ANCHORAGE AREA ItEALTH DEPARTMENT Anchorage, Alaska 99501 9ROUGH 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT MAILING ADDRESS PHONE NO. LOCATION OF INSTALLATION NAME OF APPLICANT RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK. TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH_ PERCOLATION TEST RESULTS , SEEPAGE PIT ,DRAIN FIELD TO BE INSTALLED BY ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT .,OTHER_ THIS IS TO SERVE AS DISTANCES: , PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED SEPTIC TANK SIZE · TYPE SEEPAGE AREA .,TYPE DIAGRAM OF SYSTEM NOv 1 o ].969 Health Authority I certify that I am familiar with the requ~ements of Greater Anchorage Area Borough Ordnance No. 28-d8 and that the above described system is in accordance with said code. gATE APPLICANTS SIGNATURE Alaska 99577 SUBdtlCTI Sewom System on Lots 21 6 22, l~lk. 3, Ragn,ond '£od~o*~ Subd. bo ~oclifiod to ].neludo a ~opt[c tank no later ~:han ~luly 1, 1.96~. S[~ould thi~ ~p~,~nt obtain fir~ co~,~mit;~m~ ~hat ~[~e property will 1969, i~ walvo~ o.~ s~ptle tank installation can be given. A ~tate~n~ 1'his D~mrt[~nt ~ill allo~ conditional app~,ov~l of the Ray~,ond ~]ubdivL~ion ~ater Corporation well pendinE ~orreetbn of systen~ on ~he ~ubj(~et lots. to ba r,~odtfled no l~te~ than July 1, 1969, Since~lv, ~.~odieal Dirootor ['~E^LTH D.E'P/~R2% ENT 327 EgGLE STREET ~uX/CHORAGE, ALASKA 99501 279-2511 DATE I~ECEIVED INSPECT: J..,'113: REQUEST FOR APPROVAL OF INDIVIDUAL SELVAGE AND 1VATER FACILITIES FOR 1. Approval Requested Address ,///J;'~" / ~/A/J ~: '-z'~/-~'/7~ .... Phone .~ /~)., z' . 2. Property Owner ~fi(~/~ 3, Legal Descript:[on .~z ~.~:/~,~;~L_Z.' ' ' ff ~ 2 '' .... 4, Type of Facility to be Inspected~,zT/~-. Number of Bedrooms,_.~, A Type . B. Depth (,,~ ~],~, ,. C. SSze '/'~ D, Construction E. Bacterial Analysis Sewage Disposal System: A. Septic Tank (If homemade, show diagram on back) 1. Size .... 4. Instal let ~.??~A' ~22/ . ./ THE FII~ST NATIONAL BANK OF ANCHORAGE P. O. BOX 720, ANCIIORAGE, ALASK.k 99501 Main Offtce March 25, 1971 Mr. John R. Lee Greater Anchorage Area Borough Health Department 327 Eagle Street Anchorage, Alaska 99501 Re: Lots 21 & 22, Blk. 3, Raymond Tedrow S/D Dear Mr. ]Lee: Attached please find Health Authority Approval forms to be completed by your office, !~indly return them to ~qy attention. Thank you for your cooperation in this matter. 'Very truly yours, /?. (Miss) Ann L. Boisvert Insured ~oan FHA Farm 2573 Rsv. July 19SD Farm Approved Budget Buleau No. 63-R296.$ HEALTH AUTHORITY APPROVAL iNDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA iNSURING OFFICE MORTGAGEE SERIAL NO. Anchorage, Alaska First National Bank o£ Anchorage LH 178 4R0 MORTGAGOR OR SPONSOR I~elley, l~atrick M. & 3oanne T. SUBDiVISiON NAME 1Kaymond Tedr ow J--] New installation PROPERTY ADDRESS NHN Dawn St. , Eagle River ~ BLO~K NO. I,LO T NO. 1 &22 TOTAL NUMEIER~r ] BASEMENT 2 4 ] 2 [X~ Yes [] No WATER SUPPLY ~,.3~u b lic system SEWAGE DISPOSAL BYz ~ Public system [~ Community system ["-~ Community system Can attic or other area be made Into addltloflaJ bedrooms? (If Yes, how [] Individual [] Individual SYSTEM DESIGNED FOR PART II.~TO BE COMPLETED BY HEALTH DEPARTMENT ~EALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the U] State E] County ~ Local Department of Health that this individual water-supply system g is [] is not satisfactory as a domestic water supply for the subject property. PUBLT0 WATE[3, It is the opinion of the E] State rem with proper maintenance: ~Can be expected to function satisfactorily, and E--] County ~] Local Department of Health that this individual sewage-disposal sys- [~ Cannot be expected to function satisfactorily '~ATE is not likely to create/an"4nsanit~rYs~AT~ ~ conditi~on/) /~.,) ITM PRIMARY TREATMENT consists of [] Septic tank. [] Cesspool. Septic Tank: Distance from well,__ Total liquid capacity, Inside length,_ Cesspool: Distance from: Well, Inside diameter,_ feet. Material Number of compartments gallons. Capacity inlet compartment,. feet. Inside width, feet. Liquid depth,. .&et. gallons. feet; fi)undation, feet; nearest lot line at C] front, [] side, [] rear, feet. Depth, feet. Liquid capacity, gallons. Lining material SECONDARY TREATMEI~T consists of [] Tile disposal field. [] Seepage pits. Other Tile Disposal Field: Distance from: Well,. Total length of tile lines. Trench width Length of each line Type of filter material: [] (}ravel. [] Broken stone. Other Depth of filter material beneath tile,, .inches. Seepage Plta: Number of pits .... Outside diameter. _feet. Depth, Distance from: Well, 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, Depth of filter material over tile,. feet. Lining material __ feet. .feet. square feet. inches. Inspection made by: [] State. Date of inspe<tion__ inches. feet; building foundation, feet; nearest lot line at [] front, [] side, [] rear, [] County. [] Local Health Authority. Inspected by 19____ ITM) feet. REPORT OF INSPECTION~INDIVIDUAL ~ATER-SUPPLY SYSTEM Distance to nearest public water main .... feet, Size of main, inches. Individual wells [] are [] are not custo~nary in neighborbood. Give most recent record of failure nf wells in immediate vicinity to furnish adequate supply of water. Properties in neigbborb~md [] are [] are not being developed 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. Distance of well from: Building foundation cast iron sewer, seepage pit, Wall construction: Diameter,_ 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. _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. Pure,: [] Shallow well. [] Deep well. l. ength of drop pipe,, feet. Pump capacity, h~cated in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground, [] Pump pit. Pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No. Type of storage: [] Pressure. f-] 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. [] ha<al Health Authority, Inspected by Depth of casing, gallons per minute. gallons per minute. 19 feet; feet.