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HomeMy WebLinkAboutBROOKWOOD BLK 2 LT 13 _ ~ ~ ~ MUNICIPALITY OF ANCHORAGE ~~~ DEPARTMENT OFHEALTH & ENVIRONMENTAL PROTECTI~'~;:'~Jiu~:';~:~'~:-'?~!. t ,:,~ :~'~'!_~¥© ~~ 825 L Street - Anchora., Alaska 99501 · /~t~ - . ~~ ENVI RONMENTA b ENGINEERING DIVISION ~ ~- Telephone 264-4720 R~UEST FOR APPROVAL OF INDIVIDUAL WATER AND SEwER~*~i~ DIRECTIONS: Co~lete alt parts on page 1. Incomplete tequ~ will not be proceed, Please allow ten (10) days for processing. Ernest~ -Niemi . 8R~ BO~ ~506 J Anchorage, AlaSka 99507 PROPERTY RESI~NT (If different f~0m above) PHONE - 1~09 R~inbow Ave. Anchor~ge~ Al~sk~ ~9504 .'.. Jer_ome~V. Esau MAILING ADDRESS SAA 3o~ ~3~0 3 Anc~o~se~ Alss~ 3, -LENDING IN[~TUTION I PHONE ~e ~o~;~s & ~e~C[e~on Co, MAILING ADDR~S , 444~ B~siness Park Blvd. ,Anqh~rag~ ~laska 9~503 .. 4.. A TO./A T . .HONE- Bowden~.~e aIt~ I 278-35~1 ~01 E.~Firewe_ed.L~ne Anchorage, Alaska ~50B IB.-rLsGAL DESCi.imTION I Do~ 13~: Btk 2 Brookwood s/d I STREET LOCATI'~ .... I._. 190.9 R %nbow Ave. ,Anchorage; Alaska 99504 16. TYPE OF RESt_; !ENCE I~UMBER OF BEDROOMS ' ~:~ S NGLE FAMILY ~ One ~ Four ~ Other - ~ Two ~ Five ~ N ~LTIPLE FAMILY ~ Three ~ Six 7, WATER SUPPI ~ I~DIVIDUAL* * ATTACH WELL LOG. A we log s required for all wells drilled ~ COMMUNITY since June 1975. For wells drilled prior to that date, give well ~ P~BLIC UTILITY depth (attach log if available.) ~ I~DIVI DUAL/ON-SITE** If individual/on-site, give installation date . ~ If system is over two (2) years'old an adequacy test s requ red ~ P~BLIC UTIL TY b thisDe artment NOTE: THE I~PECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ~r 72~10(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTI LITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: If Tank is homemade give dimensions: TYPE OF TANK ' TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SiX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING MANUFACTURER MATERIAL Septic/Holding Tank IAbsorption Area ]Sewer Line [] OTHER INearest Lot Line [] APPROVED FOR BEDROOMS []~ CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE I BY (Title) I LEGAL DESCRIPTION 72-010 (Rev, 3/78) '5, ~O,qD 17'2 163 171 ~(~ 173 178 Rabbit Creek Area Reference Map-PI3 1914 JH ~{obert C. P~att~ ~k.:2.. ~,,an lta.r ia.,. ~ Departmen~of EnvironmentaJ ~uality 3330 ,C" Street, AnchoraGe, Alaska 99503 274-456.1 . .~~~~ ~'U Date Received March 19, 1976 Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR v.ao 1. Approval requested by: Coast Mortgage Company Mailing Address: Post Office Box 1200, 99510 Phone: 279-0665 2. Property Owner: Leon D. Mc Ginnis Mailing Address: 1909 Rainbow Avenue Phone: 4. 5. 6. Legal Description: Lot 13 Block 2 Brookwood Subdivison Location: 1909 Rainbow Avenue Type of facility to be inspected Single Family No. of bedrooms ~~),~, Well Data: Community Well A. Type ~0' C. ConstruCtion d~~flr Sewage Disposal System: ^. Installed 1966 B. Depth D. Bacterial Analysis On0site system B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8, Distances: A. Well to: Septic tank , Absorption area , Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality ~.PT.o~m/,,~_n.~c~ ENVIRONMF, N'iAi_ FliO IECFION 3330 "C" St., Anchorage, Alaska 99503 - 27~-4561 MAR q' 976 1. Type of Inspection: 2. Property Owner: Mai.ling Address: 3. Name of Buyer: Mailing Address: CMRO VA Leon D. MgGinnis 1909 Rainbow Ave, Ernes~ ~.. Niemi Jrt 21-~01E Lemon Ave, FHA CONV 4. Name of Lending Mailing Address: 5. Name of Realtor or Agent: Mailing Address: Da,x Phone Day Phone Insti tuti on: ~,n~.,~t Mort_~:ge Co, . l~__n__ l~n~ ~poO AJ~ch. /LN.: 99~lOPhone 279-0665 301 ~ ~i~d Tm. ~eh. ,, P ho ne 278-3541 Legal Descri pti on: ..... Lot 13, Block.2, Brookwood Subdivision Locati on: 19o9 7. Type of Facility to be inspected: Single F~.m~ly No. Bdrms. 2 8. Water Supply ~00KN00~ C0~-NI~~ Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System' Public Utility Individual (on-site) If Individual, date of installation. 1966 EQ-037 (!/74) Page 2 of two pages - R~ ~st for Approval of Individual ~er & Water Facilities Legal Description Lot 13 Block 2 Brookwood Subdivision Comments Approved lDisapproved Date ~"/°7~ id for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) FHA Form 2573 Form Approved Rev. July 1958 FEDERAl. HOUSING ADMINISTRATION Budget Bureau No. 63-R296.8 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. .~horage, Alaska FirBt ~atio~al Bank of Anchorage 60-007438 MORTGAGOR OR SPONSOR PROPERTY ADDRESS Allan J. Harris K~ehorage~ Alaska SUBD,V,S,ON NAME ~rook~od Subdivision BLO~ NO. L~O. __ [] Can attic or other area be made into TOTAL NUMBEa: BASEMENT New installacion additional bedroom,? UWNG u~rs ss~oo~s ~AmS ........... (If Yes, bow many~) WATER SUPPLY BY.' SYSTEM DESIGNED FOR SEWAGE DISPOSAL BY.' PART II.~TO BE COMPLETED BY HEALTH DEPARTMENT ..... ~ ---~- _ ~-~- - . z_I a::-.-: .-- ...... --,,.., , .' ~ ' ---~ M ..... ~ .... ~ It is the opinion of the [--] State [~] County [~ Local Department of Health that this individual water-supply system [--] is ['~ is not satisfactory as a domestic water supply for the subject property. 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 SI~NATURE TITLE NOTE: The health authority should complete the ropriate opinion statement abov and effJx date, s gna ure and title Jn the speces provided, Use of the above grid for Health Department Inspector's sketch as well as use of the back of this form is at the option of the health authority, PARt III,--FOR USE OF FHA OFFICE TO ?Hi CHIJ~ UHDJRWRITERj 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 SIGNATURE FJ CHIEF ARCHffECT J -'-J DEPUTY FOR CHIEF ARCHITECT HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July 1958 REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY TREATMENT consists of [] Septic tank. Septic Tank: Distance from well,~ Total liquid capacity, Inside length,. Cesspool: Distance from: Well, feet; foundation, Inside diameter, feet. Depth,. [] Cesspool. .feet. Material ~"~,~ (-~ gallons. Capacity inlet compartment, feet~ Inside width, feet. Liquid depth, Number of compartments feet. .feet; nearest lot line at [] front, [] side, [] rear,~ feet. Liquid capacity, gallons. Lining material Other gallons. SECONDARY TREATMENT consists of [] Tile disposal field. ~ Seepage pits. Tile Disposal Field: Distance from: Well, Total length of tile lines Trench width Length of each line Type of filter material: [] Gravel. .feet; foundation, feet; nearest lot line at [] front, [] side, [] rear, feet. feet. Number of lines. Distance between lines feet. inches. Total effective absorption area in bottom of trenches square feet. feet. Depth, top of tile to finish grade, inches. [] Broken stone. Other Depth of filter material beneath tile,~ inches. Depth of filter material over tile, inches. Number of pits / Outside~C~ ~et. Depth., (,gD feet. Lining material Distance from: Well, feet; building foundation, ~5~O feet; nearest lot line at ~' front, ~ side, ~ rear, ,m,,floum,d. by: =State. =Counw. ~lHealthAuthoriW.insp~tedby '~""~J' ¢ J' <(et, 1~ Date of inspection_ ~ -- ~ '1 REPORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM Distance to nearest public water main, __ feet. Size of main, .inches. Individual wells [] are [] are not customary in neighborhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborhood [] 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, feet; tile sewer, seepage pit, feet; cesspool, Well construction: Diameter, Total depth, Approximate depth to pumping level of water in well, Sealed watertight to 4~pth of feet. Exterior space around casing sealed with: [] Cement grout. .feet; nearest lot line at [] front, [] side, [] rear, feet; septic tank,, feet; disposal field, feet; other sources of possible pollution, feet. inches, feet. Type of casing, feet. Approximate yield, [] Puddled clay. [] Ordinary backfill. Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No. Pump: [] Shallow well. [] Deep well. Length of drop pipe, feet. Pump capacity, Located in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit. Pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No. Type of storage: [] Pressure. [] 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. [] Local Health Authority. Inspected by Date of inspection 19.__ Depth of casing, _gallons per minute. .gallons per minute. feet, feet; feet. (TITLE)