HomeMy WebLinkAboutLot 36O'IZ
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GAAB-'D-I !; GJ~,,~TER ANCHORAGE AREA BOROb'~'H
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK: ~ ~z~-~_ C~L~,;z~c~-~--
DISTANCE FROM WELL (:~ ~-~t MATERIAL ~ "~'~' ~<~-., 2g~T~[NTS ~
LIQUID
LIQUID CAPACITY ~/('~ ,2,.~'-~ GALLONS. INSIDE LENGTH. INSIDE WIDTH .DEPTH
SEEPAGE SYSTEM:
SEEPAGE PIT: ~p.~ ~. r C ~.~(
NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH ,LENGTH , DEPTH
LINING MATERIAl DISTANCE FROM WELL BUILDING FOUNDATION__
NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT.
TILE DRAIN FIELD:
' ,~...~'~~ ' /'~"~"~'~ TOTAL LENGTH
DISTANCE FROM WELL/~-~ ~, FOUNDATION. ~ , NEXt, EST LOT LINE % OF LINES
WELL:
TYPE ~: '~L_. , DEPTH ,BUILDING FOUNDATION SAMPLE , NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE , SEWER LINE , TANK , SYSTEM , CESSPOOL , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
APPROVED
GLA,A,B,
uREAT_R AN~,ttORAGm AREA BO.~OUGH
Department of ~n~i~ommental (~uality
.~500 Tudo~ Road, Anchorage, Alaska 99507 279-B6B~
Time of Insmection
Date of Insovctzon
Address:
~hone:
4. Location __~
5.
~ ~/ ~
Number of Bedrooms:
Well Data: ~
A.' Type. B. Dept,h__
m
C. Construction D. Bacteria] Analysis'
A. Insta 11 ed ~ '~,~_~2~ B. Instal ].er
C. SePtic Tank: ]., Size , _ 2. ~anufacturer__
D. Seepage Pit: !. Size 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
Request for Aporoval
?~.~e T~O
\~.~9- Gomments:
of ~.~ividua] Sewer & Water Facilitie
Aporoved y l~'~ P1,,approved Date /~-f--7~
Approva? Va}.id for One Year From Date S~gned
Greater Anchorage Area Borouoh, Department ':~f Environmental Quality
I certify that the information contained in this request for approval to be a true
and accurate representation of the subiect sewer and water faci!it~es located at:
Signed Date
EALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SFWAGF DISPOSAL SYSTEM
INSURING OFFICE
Anchorage
MO,TOAO0~ O" S~ONSOR
Yrank Pollins 344-8081 or 277-2531
Lawrence S. Weede
SUSDIVISION NAME
Southwood Park S/D
TOTAL NUMBERz
'1 I
WAt'~.R SUPPLY BYt
Public system
SEWAGE DISPOSAL
[] public system
September 14, 1972
~irat ~Ta~ional' BAnk'of Anchorage ~ Case #15651
Fq New installation
· i.o..b,
· [] Individual
[] Individual. ..
lAmS J BASEMENT
[] Yes [] No
[--]Community system
"-]Community system
PROPERTY ADDRESS
] 2617 Raapberry_~_'Anch.o.~_g~, A~,~ka 90502
. '[~LOC~ ~O, ItOT NO.
/ 4 · I 36
C~n ~c nr'olh~ a~o be soda {n~o
(If Yes, how manyf)
~Yes ~No
PART li.--TO Bi CO?&PLETED BY HEALTH DEPA~T,~I~¥
HEALTH DEPARTMENT INSPECTOR'S SKETCH '
It is the opinion or the [~ State [] County [] Local Department o£ Health that thii individual Water-supply system
_~ is [] is not ~tisfactory asa domestic wa't/et 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: X X .
[] Can be expected to function satisfactorily, and [-] Cannot' be expected to function saFisfactori'ly
× is not likely to create.~an insanitary condition ///~ ' ' ' -' '
heel~ euthorlty.
TO THE CHIEF UN~KWRITEK~
I hive ~view~ the ~regoing and the ~inent FHA Co~Plimlce Ins~ion Repo~, and recommend, that the
Individual ~ater~aupply s~stem ~ ~nsldered ~ ACceptable ~ Not Agcepmbl~
~wage dis~sal ~ conside~d ~ Acceptable ~ Not Acceptable,
' , DEPUTY FOR CHIEF ARCHITECT
........ KgA&¥N AU¥~IO~ITY APPD. OVAL FHA Form
INDIVIDUAL WATE~ SUPPLY AND $~WAG~ D~$POSAL