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HomeMy WebLinkAboutBIRCHWOOD PARK BLK C LT 1111 7 -~ 0 _7 Tudor Road, Anchorage, Alaska 99507 279-8686 REQUEST FOR APPROVAl, OF FO~ Number of Bedrooms: ~ ~ell Data: A.~y~e ~0~ .....~'~'~ ,J,~' C. Construction 'IK ~c<¢~f !O',g D. Bacterial Analysis A. Installed B. Installer C. Seotic Tank: 1. Size 2, Manufacturer D. Seepage Pit: ].. Size 2. Material E. Disposal Field: Total Length of Lines 8. Distances: A. Well To: Septic Tank .... , Absorotion Area , Nearest Lot line , Other Contamination B. Foundation to Seotic Tank '~ Absorotion Area C. Absorption Area to Nearest Lot Line , Sewer Lines ReqUest for Approval of P'ag~ T~o Comments: ~dual Sewer & Water Facilities Disapproved Date~/C fl/ '~</ Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities located at: Signed Date ,}une 30, ~8 ~est Northern Ltghts ~lvd. Anchorage. Alaska ~ub~ect: Lot 11, ~lock ¢, ~trch~oo~ Park Subdivision De~r $tr: An Inspection o~ tho subject propert~ revealed that the ~ell w~s fna s~all b~se~ent off,et. The well castn~ was appro~t~tel~ ~ t~ches ~bove thC ~loor ~f the offset. After cens~lttn~) with personnel fro~ th~ State ~nviron~ental ~ealth Oepart~ent. it hat been decided that approval can be ~Jven for 'the water s.yste~: by Jnsta111~ a pt~less adapter on the sys~e~'en~ extendtn~ t~e well c~stn~ to above the n~tural ~round level. This woul~ ~ean the castn~ ~oul~ ~e Just un,er the back ~orch of the house. If ~ou have any questions re~ardtn~ the ~bove information, please do not hesitate to contact this office. Sincerely, Lynn ~. Coa~ Environmental Specialist bb cc~ ~obeet guck~an SOCIAL SERVICES DEPARTMENT OF HEALTH AND ~ Section ~II~IEI~OF ENVIRONMENTAL HEALTH DIVISION OF PUBLIC HEALTH WILLIAM A. EGAN, GOVERNOR ROOM 222 -- MACKAY BUILDING 338 DENALI STREET -- ANCHORAGE 99501 June 29, 1972 L~rnn Coad, Environmental Specialist Dept. of EnviPonmental Quality GAAB 3500 Tudom Road Pouch 6-650 AnchoPage, Alaska 99507 Subject: P~ivate Well Inspection rom FHA ~0an DeaP Mm. Coad: This lettem is to confiz~n cup convePsation at the time of cup joint visit fop you~ inspection of the well located on the ppopePty of RobePT Buckman. ChapteP XI of the FHA minimum standaPds 1102-3.1, allows a well located within the foundation in amctic and sub-amctic meglons. This office mecommends locating a pPivate well in a basement offset fop ease of access in the event mepalms om maintenance amc regui~ed. The location of this well meets this mecommendation as well as the FHA reguimement that the casing in an offset well be a safe distance (at least 12") above the pumpmoom floor, that the floor he concPete and the well casing covemed with an adequate san- itamy seal. It is the opinion of this office that this well does meet the minimum PequiPements and could be approved as is. The addition of a pitless adaptem as well as extension of the standpipe would offer additional protection, but would not necessamily be Peguimed. SincePely, /TJos~_ph S. Bl.aim, R.S. Reglonal SanltaPian JSB/jf BECEIV~ED, 2. 3. 4. 5, REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES (Fill out in Trlpllc~te) ~ame .of person requesting approval ,~. wSf'~ Well data: a. Type. . ~/'//~y~ . c. Casing Size Distance from well to closest existing or proposed: 1. ~ewer line 2. Septic tank 3. Seepage Area . ~. Cesspool' . 5. Property Line houses, barn, drainaEe ditch, etc. Other sources of possible contamination, i.e., creeks, lakes, Sewage disposal system. a. Age of system . . b. Septic tank capacity in gallons Name of septic tank manufactu~.r 1. If "home made" show diagram on reverse side of this form. d.' Disposal field or seepage pit size and type .... 1. Distance to proper~y line to house f~undation Percolatio~.T~st~esults f. Percolation Test performed by Use the revePse.side of this fomm to show diaEram. Diagram should include ~he following information: ~Foperty lines~.well location, house location, %%ptic tank location, disposal area location, location of percolation test~ and direction of ~Pound slopel The in£o~wstion on this form is true and correct to the best of my knowledge. ~ -~i~natume Of AppllCa~ Date S'igne~ ~0 BE iFILLED ou'r BY HEALTH DEPAET~.~ENT PERSONNEL ~'T~e above described sanitamy facilities are hereby approved, subjelc~ to the 0onditlons: The above described sanitary facilities are disapproved for the following reasons: valid fo~ one year following the date of approval. CPJ:cw