HomeMy WebLinkAboutHIGHLAND PARK BLK 5A LT 1B1A
GR~TER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION ,.~,/~ v/~7-A. ? ,
SEPTIC TANK:
LIQUID CAPACITY d ~'?'"~"~"~ GALLONS.
INSIDE LENGTH
NUMBER OF
~ C~"OI~ P A RTM E NTrS~ x/
///_.L/ ,~ LIQUID
INSIDE DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL~
NEAREST LOT LINE
SEEPAGE PIT:
~ ~,/
OUTSIDE DIAMETER ' ' OR WIDTH _, LENGTH , DEPTH
/
TILE DRAIN FIELD:
/--'~ TOTAL LENGTH
DISTANCE FROM WELL ..-~"~'~ , FOUNDATION / , N.Z'AREST LOT L NE ~.~.~E-.,OF LINES
DEPTH: TOP OF TILE TO FINISH GRADE,'.
WELL: TYP
DEPTH OF FILTER MATERIAL BENEATH TILE
DISIANCE FROM
DEPTH ~ ,BUILDING FOUNDATION.
NEAREST ~.~.~ SEPTIC SEEPAGE
LOT LINE '6"/ ., SEWER LINE . TANK ~ , SYSTEM
DIAGRAM OF SYSTEM
DISTANCES:
WATER IN~,7 V E TILE
~)/z( SAMPLE /,L"~ , NEAREST
OTHER
/-..-/ , CESSPOOL ">" , SOURCES
DATE
APPROVED
GREATE¥ 4NCHORAGE AREA '-' 9ROUGH Case No.-~_.~._.
HEALTH DEPARTMENT /
327 Eagle St. Anchorage, Alaska 99501 279.2511
..... LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK ~GEPIT ,OTHER
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
PEFtCOLATION TEST RESULTS
, DRAIN FIELD_
TO BE INSTALLED BY
ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS '1'0 SERVE AS. : , PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
SEPTIC TANK SIZ~_~.-~-- TYPE .SEEPAGE AREA _TYPE
/~'"~ DIAGRAM OF SYSTI"M
HEALTH AUTHORITY
OR
LICENSED DESIGNER
DIS'rANCES:
I certify that ] 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.
DATE APPLICANTS SIGNATURE
FHA Form 2S73 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Form Approvod
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I.--TO BE COMPLETED BY FHA
INSURING OFFICE MORTGAGEE
Kessler/West Mortgage Corporatiot~ERIAL
NO.
_ Anchorage 604 E 6th,r Anchorage, Alaska ~HA 011 291 203
MORTGAGOR OR SPONSOR J PROPERTY ADDRESS
/
Lot lB1, Block 5, HIGHLAND PARK, Anchorge
Gene JDhns on
SUBDIVISION NAME 1BLOCK NO.
/
Highland Park
TOTAL NUMBER:
BATHS
BASEMENT
J J~ Yes
[~ Individaal
[] New installation
LOT NO.
lB1
Can o~'tle or other urea be made into
additional bedrooms?
(if Yes, how
WATER SUPPLY BY:
r~ Public system [] Community system
SEWAGE DISPOSAL BY~
[] Public system El Community system ~c Individual
NO. SYSTiM DESIGNED FOR
/
PART II.---TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
It is the opinion of the [] State [] County F~Local Department of Health that this individual water-supply system
:[~ is E-'] 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 SIGNATURE ~ / / //Z '
15, 1970 J -~}~ ~/~['~'~-'~/ ~' Environmental Health Supervisor
~poce~ provldod. / & '
Use of the above grid for Health Department Inspector's sketch as well os use of tho back of thJl form is at tho option of tho
hoal~ authority.
PART Ill.--FOR USE OF FHA OFFICE
TO TIlE 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 coasidered ~'-] acceptable [] Not Acceptable.
SIGNATURE
.... HEALTH AUTHORITY APPROVA~--
IMl~ltlrll~tl,~t WATID 4IIIDDIY Xldfl ClW&f~l r~lCef~Ai ~VtfKId
] CHIEF ARCHITECT
] DEPUTY FOR CHIEF ARCHITECT
FHA Form 2573
R~v. July 1958