HomeMy WebLinkAboutBROOKWOOD BLK 1 LT 1101 ,- 181-
GAAB-HD-I
GP'rATER ANCHORAGE AREA BOROP '~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
PHONE __
DISTANCE FROM
LIQUID CAPACITY 6 ~'"'~
GALLONS.
(f.~,-)~l/~.~. ~ ,j~ NUMBER OF
MATERIAL
INSIDE LENGTH INSIDE WIDTH / DEPTH__
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PiT:
/
.i / / j
o~,s,~o,~,. --~ o~w,~,~C,/.~ ,~o,. f,' .~,. ~ ,
/~~-
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
D,STANCEBETWEEN LI~t TRENCH W,DTH IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TIL~ FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
DISTANCE FROM WATER
~ , BUILDING FOUNDATION. ~?,~ SAMPLE NEAREST
SEPTIC SEEPAGE OTHER
TANK ¢9r'~ , SYSTEM L~ , CESSPOOL
LOT LINE
DEPTH
NEAREST
, SEWER LINE
DISTANCES:
DIAGRAM OF SYSTEM
APPRO . ' ~ 'I~EA~TH AUTHORITY ~
DATE
GREATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
rfo~med For ~ ~t~/~/,,t~Zz ~'~,,u~. ~o Date Performed ~/-?-
This Form Reports a: Sdi~s Log _ _~_ _ · .Percolation Test
Depth
Feet
Was Ground Wateu Encountered?
Yes, At What Depth__ _
L
Location Sketch
Reading Date Gross Time Net Time Depth To H20 ){et Drop
Proposed Installation= Seepage Pit / Drain Field
Depth' Of Inlet Depth To' ~'o~tom Of' JP~it Or Trench-
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279-8686
Date Received
Time of Inspection
Date of Inspection ~
i~~_ REQUEST FOR APPROVAL' OF
%~ INDIVIDUAL SEWER g WATER FACILITIES
1. A!~proval Requested By:
. Legal Description- /Z, ~
4. LoeatSon:
5. Type of Facility to be Inspected:
Number of Bedrooms:
Well Data:
A. Ty~e
B. Depth_ . .
C. Construction
D. Bacteria] Analysis
7. Sewage Disoosal System:
Aii!'i Installed / ~ 7o
Cj Septic Tank: 1.
D. Seepage Pit: 1.
Size /~r~/ 2.
Size 2.
Installer
Manufacturer
Materiel
E. Disposal Field: Total Length of Lines
8. Distances:
A, Well. To: Septic Tank
, Absorption Area
, Sewer Lines
, Nearest Lot Line , Other Contamination
~o Foundation to Septic Tank~/O / "~ Absorption Area ----~3~i'
C. Absorption Area to Nearest Lot Line ~0 ~-
Request for Approval o
Page'Two
9. gommen
-
Approval Valid for One Year From Date S~gned
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 faci!ttfes located at:
Signed Date
July 27, 1973
Coast Mort~.iagc Co.
700 "C" Street
A~c,orag~, Alas~,a .
Lot 11, ~lock 1
t)rookwood Subdivislc,;~
Dear Sir:
This office conducted an inspection of th. subject PraF:erty
July ;:5; 1973. Thc residence is scrv~.:.~ ty ~n J~prov~d
commu~)i~y water svst~:~., t~erufore no wats~r sa~n)¢ was
of a ~-':;:>tic Cank and seepage pi~. Tn~ s~epag~:. ?i'c i:~ shallow
(3'
SANI FARIAN
SL~/ko
E~closurs
CC:
Garland Tyler
Veterans Aomtnlstra.:to;i
AUG 9, 1973
TO WHOM IT MAY CONCERN:
I, GARLAND A. TYLER, HAVE LIVED AT RAINBOW AVE,
BROOKWOOD SUBD, LOT 11, BLK 1, FOR THE PAST
THREE YEARS.
THE CESSPOOL SYSTEM HAS BEEN WORKING FINE AND
HAS BEEN PUMPED ONCE IN THREE YEARS, ONLY THEN
BECAUSE WE THOUGHT IT MIGHT NEED IT, NOT BECAUSE
OF ANY TROUBLE.
OUR FAMILY CONSISTS OF FOUR PEOPLE.
GARLAND A. TYLER
A, ' ''
Form Approved
FHA Form 2573 u.s. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Budget Bureau No. 63-R296.8
Rev. July ! 958 FEDERAL HOUSING ADMINISTRATION
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I.--TO BE COMPLETED BY FHA
'~NSURING OFFICE MORTGAGEE SERIAL NO.
An~hor~$e~ Al&~k~ Ftrst Feder~ ~a~v~z~B ~ ~ 111-01~0
MORTGAGOR OR S~NSOR PROPER~ ADDRESS
Cec~ ~u~e Conetr, ~a~ow Rd ~cho~
SUBDIVlSIONBr~~.~M~ I ~oc~ IN°' LOT
TOTAL
NUM~R~
Can ~ ~ o~er aNa be mede in~
EASEMENT
~ New installation aNiflonol b~oms?
LIVING UNITS SED~OMS SATflS
(If Yes, how martyr)
W/~l SUP~Y I% SYSTEM DESIGNED FOR
.~~ Public system ~ ~mmuni~ system ~ Individual .o. o,
GARBAGE ~DISPOSAL
SEWAGE DIS~SAL BYz
I ~blic system ~ ~mmunity system ~ Individual ~ ~ Yes ~ No
PART fl.--TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPE~OR'S SKETGH
.........................
It is ~hc opinion of the ~ State ~ Coun~ ~ Local Department of Health ~ha~ this individual water-supply system
~ is ~ is no~ satisfactory as a domestic wa~er supply for the subject properS.
the opinion of the ~ State ~ County ~ Local Department of Health that this individual
It
is
sewage-disposal
sys-
tem with proper maintenance:
~ Can ~ exp~ted to function satisfactorily, and ~ ~nnot be exacted to tun.ion satisfa~orily
~s not likely to create an insanit~ condition
D~TE
SIGNATURE
TITLE
NOTEj The health ~orJ~]lhould. complete the Jpproprlatl opinion statement above and a~x date, iljnnturt ~nd title in the
sPa~bS Provided. ~,
~ Use of the above g~d 'for Health Department Inspoctor's sketch as well as use of the back of this form is at the option of the
heal~, a?ho~ity: . .
PART III.~FOR USE OF FHA OFFICE
TO THE CHIEF UN~RWRITER:
I have r~iew~ the foregoing and the ~inent FHA Compli~xce Ins~ion gepoK, and recommend that the
Individual water-supply system ~ considered ~ Acceptable ~ Not Accep~ble
~wage dis~sal ~ considered ~ Acceptable ~ Not Acceptable.
DATE SIGNATURE ~ CHIEF
DEPU~ F~ CHIEF A~CHITECT
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATIR SUPPLY AND SEWAGE DISPOSAL SYSTEM
FHA Form 2573
Rev. July 1958