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Home My WebLink AboutSUNSET HILLS BLK B LT 6Onsite File M -W Drilling, Inc. ♦P.O. Box 110378#Anchorage, AK 99511• ♦907-345-4000 • 907-345-3287 Fox* Job No.: 04-102 Project No.: N/A Permit No. N/A Groundwater Well As -Built A LoQ • Well Owner. Kirkwood, Larry & Susan ♦ Use of Well. Domestic ♦Legal Description: Sunset Hills, Block B, Lot 6 Construction ♦]late Depth: 180' ♦ Casing Size. 5" Cased To: 180.37' ♦Afaterlal: A53Steel ♦ DrU1 Method: Air Rotary 6" 160' A 53 Steel Perf. ♦ Well Completion- Open end x Screen Per _ Method: ♦Screen/Perforadondescdption: None ♦Grout Notes: (1)Sack- No. 8bentonite gmnules 4 Notes: ♦ Well Development. Method: Airsurge Notes: e Static water level (SWL) 95' (ebeve) (below) lop of casing (TOC). • Well yield lest a1 20 gallons per minute (GPM)/ga1kmq per hoer(GVH)for with 100% of drawdown (DD) from static level (SWL). ♦Method: Airlift hours ♦ Date of completion: 23 February 2004 • Pump Install.• 25 February 2004 Well Loa Depth In feet from top of Casing. Details of formations penetrated, stze of material color and hardness. 0 TO 3 Casing stickup 3 TO 160 Existing well 160 TO 165 Silty gravel: less than 2 gpm water sea 165 TO 180 Water vel: slightly sandy/silty,good saturation TO TO TO TO TO If TO TO -` W VVA Certified Conhactc. Ufieate-H . TO TO TO TO TO TO S'Fikl'E, OF ALASKA DEPARTMEENM OF FNVIRO-NMINTAL CONSERV-PO N CONSTRUCTION AND OPE CERTIFICATE PCIR D 0 M E SM C WASTE NVA T E R D ISP 0 S A L SYS TEM S A A. APPROVALTOCONSTRUCT Plans fbr tile con'struction 0tqft0difiCVt= Of , !> domestic wutewaller disposal system located in, A)lt Alaska, milli 18 &AC72210 bV j/ have been rev ewed and;ac approved. i5' t' 4 A d (see amehad conditions) conditional�y approved f 31411 If coristrtiction has not stwed wiflihi two, year,-; of to approval date, this certificate is void, wnd -new plans and sped fiuitions lawt, bv submirted for review and appwvai before construction. 8. APPR UIVEDCHAINIGUORDERS Change (conn-mt order number or descriptive refer"not) Approved ti D C APPROVAL TO OPMAM, The "APP" -OVAL TO OPERATE" section must tie completedtil signed by the Npartment befomthis system is made ay4ijlablee for use. AI � , " �' �" 'e �'-' 5�" The construction of the dinniestic wastewater djzpAisial systiam. was coMP14:ted; ate}. I'lic systent is hereby granted jottrim approval to operate fit 90 dkvq IFF611ourin the, cam pletion dale. riy TME As-buill/recard dramvingsa submitted, to the Departntent, or art inspe'aion by the Fannie rt, has catifirmcd thm !bc tioniestu; %wtewacr dispoaal system was constructed irt substantial conformanc-c with the approred plans, final approval to operate, (Rtv 41911 p DWributiom 14 W h; ic, -17 ngtwx "r (�,' le" to P1 t 0, S C Ck- I (Coalpl= Stai �a C) PROJECT N. 588 LOT 6, BLK. B 1993. 4" D-3034 PIPE 1.F.A. ISCHED, 40 PVC 25 fu D TWOE x 50'LON(� .011- ABSORPTION DPWNFIELD "E PLAN VIEW SCALE: V = 301 GARAGE RussEffim I FROM: COR, "N' COR. "B" TO: StOCYCLE 'C- $IX' 76.61 MON. TUBe"D` 81' 77X' MON. TUBE"E" KV 101.60 4' Oik GROV'NO SJPFASCE fllvc G LL N 0 A �'j 1500 GALLO, CLA S 151 H"n 01 1 A -LES CYCL "1310C'YCLE" - rRom HoJW "B" WELL AEROBIC TREATMEN[T TMS SOIL NIT U IT cor, "P, ill ;;v lcu.u) <1 4" D-3034 PIPE 1.F.A. ISCHED, 40 PVC 25 fu D TWOE x 50'LON(� .011- ABSORPTION DPWNFIELD "E PLAN VIEW SCALE: V = 301 GARAGE RussEffim I FROM: COR, "N' COR. "B" TO: StOCYCLE 'C- $IX' 76.61 MON. TUBe"D` 81' 77X' MON. TUBE"E" KV 101.60 4' Oik GROV'NO SJPFASCE fllvc 151 H"n 01 1 A -LES N - rRom HoJW srlcyctl'�" CCVEI;� SOIL X3 4ARGE TREATMENT UNIT LESEND I PkWAR Y �_��TTJJrj;r, CHA VFlf,,K 2 AER.A7'CY,,l CHAMBE—R lFR.A NON '_' �WtTER cliAmmR 0 V, �v s 51 8 "NATER W4r' RESIDUAL DISPOAL— DRAINFIELD LOT 6, BLK. B, SUNSET HILLS SID CROSSESECTION SEPTIC SYSTEM UPGRADE AS -BUILT INSPECTION REPORT FLAT70P ITCHNICAL SERVICES I SCALE: AS NOTED 1453f) FC110 STREET i DRX4VN BY TFM ANCI IORAGE, -'J-AS�99516 AUGUST, 1999 OT 6, BLK B, SUNSET HILLS SEPTICM-UPGRADE SITE PLAN 1 INCH 40 FEET S B Y TFM ANCHORAGE, ALASKA 99516 JUNE, I -M NOTE,- THIS IS NOT A SURVEYED FLAT. 1 1i4" SCHEDULE 40 PVC DISCHARGE LINE TO SOIL ABSORPTION RAINFIEL EATMENT UNtT 4" DIA. D-3034 INLET FROM DWELI. N d" ITS. ID -3034 LINE FROM HOUSE _ # 3. 9 PLAN VIEW FINAL GROUND'SUPFACE BIOCYCILE COVER 5..11 C-t0P *..'x"'' SOS PUMP TREATMENT UNIT LEGEND 1 PRIMARY SETTLING LIN CHAMB z AE ATIO'N CHAMBER 3 - CLARIFICATION H(�IJIBEF 4 DISSCHA GE CHAMBER FABRIC 1 1l4" SCHEDULE 41 PVC ENSCHAP LINE i 3 I E L ABSORP T ION D AINFIEL SAND OR GRAVEL BACKFILL F A INSULATION O EXTERIOR OF Bl '(CLE —_2" BLUE B A LI INSULA11N _ � SAND Lt -V L! ate COUSE 'SOIL COVER , � ` BOTTOM OF f EXCAVATION ION SEASONAL HIGH #ATERTABLE RESIDUAL DISPOSAL.. DRAtNFIF- I CROSS-SECT ON LOT 6, B1_K tLJNS'El' LS SiD PLM; AI\ CROSS-SECTION I,A`1`E()P°IACT.,.I41t:::+`LS%I<V[CPS 3':A I° 5'-W' 1-15,301,17 CTIC) 9 TREIE T DRAWN BYE TFIVI 1,25" PVC DIST. PIPE., - gra"` HOLE SPACED � 3 " x 3 MONITOP TUBE i .w " RESIDUAL I DISPOSAL RiNF 1,25" IIIA. PVC N40NIT R W 118" HOLE — — TUBE E SPACED:��I' FABRIC 1 1l4" SCHEDULE 41 PVC ENSCHAP LINE i 3 I E L ABSORP T ION D AINFIEL SAND OR GRAVEL BACKFILL F A INSULATION O EXTERIOR OF Bl '(CLE —_2" BLUE B A LI INSULA11N _ � SAND Lt -V L! ate COUSE 'SOIL COVER , � ` BOTTOM OF f EXCAVATION ION SEASONAL HIGH #ATERTABLE RESIDUAL DISPOSAL.. DRAtNFIF- I CROSS-SECT ON LOT 6, B1_K tLJNS'El' LS SiD PLM; AI\ CROSS-SECTION I,A`1`E()P°IACT.,.I41t:::+`LS%I<V[CPS 3':A I° 5'-W' 1-15,301,17 CTIC) 9 TREIE T DRAWN BYE TFIVI FLA TITOP T1 ECHNICAL SERVICES 14530 ECHO ST: - I ANCHORAGE, ALASKA D95,16 TEST H01 -E # 1A SOILS LOG -- PERCOLATION TEST LEGAL OrISCRIP11,011: Lot 6, Slo k,"B", at 1+115--1---.1- DATE P�P(�ORMED PERFORMED FOR' Will andjftUt�)o �opC Car SLOP5 (te-, 0 IS SM Reddish sandy foarn GPIGM Orgy, someWhat silty gravel OP Clean gravet Stratum disappears at northeast end of T .K were mon-ftor, tune Irl Called Water flowing into test hole ML Dense sandy sift Blueish at top Becomes agray N%th cos itis I -lard dinefirin M SITE Pb'tN t. I LOT 6. SLK. 8 4 TH. —'sup N, �A T,H '93 TANK VIA Date 1 Reading Vock T!,T�e Net Time percornetpr 1 Net Drop (minkife,a) Peaon'ng or1rhe,4 20 PERCOLATION RATE (minutesslinch) PERC HOLE oWMiETER TEST RUN BEIVEEN 425 F7 AND 415 FT f,-OMMENTS:Theoravetstraturnt elydispp,, 'UM q q _�r€ d at NE end of test hole Where Me monitor tube was lmtallsor It mtva become isolated from the grwvetsrratum Ottlecourseof bac.10,01, and thus riot ielert the groundwator table encountered in the graveIS"turnL - --------- - -------- PERFORME08Y ;LIATTOPTECHMALSERVICES. r GERTir.-Y THATTHIS TESTVVAS PEUORMED IN ACOORDANCE VVITH ALL STATE AND MUNI09AL GUIDELINES IN EFFECT ON THIS DAT -1 DATE: /z-1, CZ i Y 4 M 0 "A' SITE Pb'tN t. I LOT 6. SLK. 8 4 TH. —'sup N, �A T,H '93 TANK VIA Date 1 Reading Vock T!,T�e Net Time percornetpr 1 Net Drop (minkife,a) Peaon'ng or1rhe,4 20 PERCOLATION RATE (minutesslinch) PERC HOLE oWMiETER TEST RUN BEIVEEN 425 F7 AND 415 FT f,-OMMENTS:Theoravetstraturnt elydispp,, 'UM q q _�r€ d at NE end of test hole Where Me monitor tube was lmtallsor It mtva become isolated from the grwvetsrratum Ottlecourseof bac.10,01, and thus riot ielert the groundwator table encountered in the graveIS"turnL - --------- - -------- PERFORME08Y ;LIATTOPTECHMALSERVICES. r GERTir.-Y THATTHIS TESTVVAS PEUORMED IN ACOORDANCE VVITH ALL STATE AND MUNI09AL GUIDELINES IN EFFECT ON THIS DAT -1 DATE: /z-1, CZ i Y 4 M FLATTOP TECHNICAL SERVICES 14530 ECHO ST TEST HOLE 2A AN C H 0 RAG E, ALPA S f (A 9 9 51 & SOILS LOG -- PERCOLATION TEST LEGi;t- OESCRIPTRON, Lot 6, Mock, !��ixisek Hills DATE PERrORMED, PERPORMED FOR: _arle�e K, SLOPIE Peat and ash S?0 silty loam GPIGM moray, sornewhatstir giro rel Soft, many cobbles Scattered water sie eps SMIAL BlUelSh q ravelNr silty sand Variable M LU CL 0 M PERC HOLE DIAMETER, TE,9TRUN BEW4EEl`q 5,() IFTAND -3.6 FT ---------- CQMMEKTS.NomoNto t4��e n T,�4,h�ejnstatfed. eav Sizernore T.,K *2j foT _njo, jtor*�g. 'ou au Th8t �MOVIltik[ tUbe had oil, 400108 PERF�ORMED BY FI.ATT("�P-TECHNI-r;AL.SF—:RVICCS, CERT IPY TKAT THIS TFSTIWAS PE.�FORMED IN ACCORDAN.CE WITH ALL STATE AND MUNICIPAL GulraELINES IN EFFECT ON -rHISDA.TE, DATE PI �9-� w Municipality of Anchorage REQUEST FOR VOUCHER CHECK FROM: Health & Human Services (DEPARTMENT) TO: MUNICIPAL CONTROLLER DATE: September 10, 1997 R 82255 THIS SECTION FOR ACCOUNTS PAYABLE USE ONLY __.1~' VOUCHERNO PAYMENTDI V VENDORNO REFERENCE NO INVOICR DATE INVOICE NO CHECKNO. CHECKDATE PREP APPR 1. REQUEST THAT A MUNICIPALITY OF ANCHORAGE CHECK BE ISSUED TO: Name Carlene J. Knoppe Address 11600 Cobra Avenue Anchorage~ Alaska 99516 1265 THIS PAYMENT IS FOR THE FOLLOWING (SUBSTANTIATION ATTACHED): The application for an on-site wastewater disposal system upgraded was applied for on Aug 27, 1997. On September 9, 1997 the engineer for the property informed this office that this dwelling was a duplex and the applicant requested to pull the permit application due to the fact they were going to keep it a duplex and not convert it to a single family dwelling. Please refund the permit fee:of $320.00 Lot 6 Block B Sunset Hills S/D 3. DISPOSITION OF CHECK: (1) X~ MAILTO PAYEE (2) [] MAILTO PAYEE WITH ATTACHMENT (3) ~ NOTIFY PAYEE TO PICK UP IN TREASURY Phone #: (6) E) Org. #: AUTHORIZED USE ONLY NOTIFY DEPARTMENT EMPLOYEE WHEN CHECK IS READY IN FINANCE Phone #: 4. ACCOUNTS TO BE CHARGED: ITEM ENTER ALL POS]TIONS OF ACCOUNTING DISTRIBUTION NO, DESCRIPTION Crc/CC AcclJObI Task -- Opt Cost Cir. WaJWo AMOUNT 1 S~.w~r P~r i:, O~- i e 5'0 9~21 _; ~20.~_0~ 5. TOIAL AMOUNT OF CHECK $ 320.00 6. SIGNATURES 343-4744 Employee ~hone No. Approving Authority 7. INSTRUCTIONS a. To be used only when payment cannot be made by purchase order, travel expense report, travel authorization or petty cash. b. Must be approved by depadment head unless approval authority is delegated in accordance with Policy add Procedure 24-7. c, Retain carbon copy for your tile. 40-001 (Rev. t1/94)' MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Sewer/Well Permit Application NOTE:Ap~icatJon muslbe filt0dout completely SINGLE FAMILY DWELLING Property Owner Name /~¢1¢~. ~?{ff4//'°'/?, ~/c'¢f,/f /Y//'//-~':f?(:' Day Phone Mailing Address Zip Code Parcel Identilication Number Lot Size ? / ,~ ~, Acre~Sq. Ft. inspections will be conducted by: Number of Bedrooms ¢~ ~c'~5 ~.% ~ ~o'~%~[ Municipality (permitfee included) Does your house contain any of the following: Hot Tub, Swimming Pool, Therapy Pool, Jac.zzi, or Water So*ener Unit_ ~ lf yes, whichone? ~ ~. This application is for: Sewer Only Sewer and Well Sewer Upgrade r I oedi~ that the above information is correct. I fudher cedi~ that4his application is~ein~ fo~ a~ingle and in accordance with applicable Municipal Codes. Fees: 72-012 (Rev. Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Services Division Telephone: 343-4744 ON-SITE SERVICES FEE DOCUMENTATION Date Paid: b / ,-// / Name of Payer: (Name on Check) Mailing Address: (Off of check) /( (:/~, - /~,--~ ~.-, Legal Description(s): ~,~ OS-03088 Permit Number: Type of Payment: (Indicate Amount Paid) ~ealth Authority: Sewer & Well Permit: Well Permit: Sewer Permit: ~ ~-~Z. Copy Request: 72-034 (Rev. 10/87) Excavator Permit: Engineer Permit: Pumper Permit: Well Driller Permit: Tank Manufacturer: (Waste Treatment) DISTRIBUTION: WAIVERS: Lot Line: Well to Tank: Well to Field Field to Surface Water Tank to Surface Water WHITE--MASTER FILE CANARY--PROGRAM FILE 10' UTILITY 5'x58'x6.5' DEEP, 3' EFFECTIVE ABSORPTION TRENCH (SEE SHEET 2) 'E~ISTING TIMBER CRIB, REMOVE TOP. FILL W/ UNCLASSIFIED MATERI~L 1250 GAL~SEPTIC TANK (SEE SHE~' 2) FROM 'WE~L. 100' R EXISTING WELL ., LOT 6, BLOCK B, SUNSET HILL8 SUBDIVISION SEPTIC SYSTEM UPGRADE SITE PLAN ,JAMES SIZEMORE end ASSOCIATES 6410 Switzerland Dr., Anchorage, AJaska TEL.: (907)345-1572 FAX: (907) 345-9629 DRWN BY: VND CHKD BY: JF8 DATE: 8-18-97 SCALE: 1'240' P.N. SHT: 1 OF 2 1250 GAL S~ TANK DOUBLE C.O. C.O. TYPICAL EA END OF TRENCH MONITORING TUBE 5'x58' LONG ABSORPTION TRENCH PLAN 1,'=20, FILTER FABRIC III1 1111 ~1111 4"' DIA. PERF. PIPE ~ SEWER ROCK SECTION f """ "'"' J CLEANOUT MONITORING TUBE LOT 6, BLK B, SUNSET HILLS SUBDMSION SEPTIC SYSTEM UPGRADE PLAN AND SECTION JAMES 81ZEMORE 8nd ASSOCIATES 6410 8wrrZBRTLAND DR.,ANCHORAGE, ALASKA TEL, (907)345-1572 FAX: (907) 345-9629 DRWN BY~ VND CHKD BY= JFS [DATE: 8-21-97 SCALE: es noted CE{ D: q 8HT: 2 OF 2 James Sizemore & Associates Civil Engineers & Surveyors 6410 Switzerland Drive (907) 345-1572 Anchorage, AK 99516 WASTEWATER DISPOSAL SYSTEM LOT 6, BLOCK B, SUNSET HILLS SUBDIVISION 0.0 GENERAL 0.1 The scope of this project consists of installation ora 1250 Gallon Septic Tank and a 5' x 58' x 6.5' deep absorption trench containing 3.5 feet of sewer rock. The existing septic tank shall be pumped and removed. The existh~g timber crib shall have the top removed and shall be filled with unclassified excavation. 0.2 Construction shall be in accordance with the approved site plan and design drawings, Municipality of Anchorage permit with any special provisions or conditions. Deviations from the approved design drawings shall be coordinated and approved by the engineer conducting the inspections. 0.3 All construction procedures and material used to construct the system shall comply with Municipal and State regulations. 0.4 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading areas after the system is constructed and soil is compacted and mounded over the wide trench disposal field and the Septic Tank. 1.0 SEPTIC TANK 1.1 The 1250 gallon septic tank shall have two compartments and shall comply with Municipality of Anchorage Requirements. The tank shall include two 4" ¢leanouts for pumping access, 1.2 The septic tank shall be set level and shall be bedded as necessary to prevent settling or shifting of the tank. 1.3 All pipe connections to the septic tank shall be made with waterproof mechanical couplings. A ¢leanout shall be installed upstream of the tank within 5 feet of the house foundation. A double cleanout shall be installed downstream, within 5 feet ofthe septic tank. The first cleanout downstream of the septic tank shall clean toward the drainfield. The second cleanout shall be to clean toward the septic tank. 2.0 SOIL ABSORPTION DILMNFIELD 2,1 The soil absorption dralnfield shall consist of a 5' wide x 58' long x 6.5' deep trench with a total of 3.5 feet of sewer rock. Three (3.0') of sewer rock shall be placed beneath the perforated drain pipe, and this is the effective depth referred to on the site plan 2.2 The bottom of the excavated trench shall be level within +/- 2". And compacted or smeared surfaces shall be raked to allow for proper infiltration of effiuem. This includes both the sides and bottom of the trench. 2.3 Sewer rock shall be 0.5 - 2.5", screened gravel with less than 3% passing the # 200 sieve. 2.4 Cleanout pipes and monitor tubes shall be 4" diameter and installed as shown on the plans. The portion of the monitor tube extending through the sewer Rock shall be perforated. All monitor tubes and cleanout pipes shall have Waterproof caps conforming to Municipality of Anchorage Specifications. 3.0 ENGINEERING INSPECTIONS 3.1 A minitnum of four engineering inspections will be required during construction of the system. One after the septic tank is set prior to its backfill, one after excavation of the absorption trench prior to placement of sewer rock, one after placement of the sewer rock and the distribution piping, cleanouts and monitoring tubes are in place. The final inspection shall be after filter fabric is placed; the trench and the final grading are complete. 3.2 The contractor shall coordinate with the engineer at least 24 hours prior to start of construction. Ifthe contractor desires, a site visit withthe engineer prior to start of construction can be arranged. PROBABLE IMPACTS TO ADJACENT PROPERTIES A) WELLS The proposed wastewater disposal system is designed in accordance with current Municipality of Anchorage Wastewater Disposal Regulations. The proposed drainfield will be constructed in accordance with these regulations. The separation distance from wells on adjacent properties is greater than 100 ft. Therefore no unacceptable impacts are expected on the wells located on adjacent properties. B) WASTEWATER SYSTEMS The new drainfield will be constructed with good separation distance from systems on adjacent lots. Soils tests have shown the soil where the system is to be constructed is acceptable for an on-site disposal system, therefore there should be no unacceptable impacts of adjacent wastewater disposal systems. C) RESERVED SPACE/SURFACE AND SUBSUt~ACE The lot on which this system will be constructed has ample space both surface and subsurface accommodate this upgrade. The proposed drainfield should not affect adjacent properties. D) DRAINAGE The location of the drainfield will not interfere with any drainage. The area disturbed during construction of the field will be graded and sloped so as to not pond water, There fore this system should not adversly affect adjacent properties. , DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ' LEGAL DESCRIPTION:~CO'~ ~¢~,~l/~. ,~-~,~/~'~ '' Iownsmp, Range, Section: SLOPE 1 6 7 8 9 10 11 ENCOUNTERED? s IF YES, AT WHAT ~ OL DEPTH? p E SITE PLAN 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS Reading Date gross Net Depth to Net Time Time Water DroJ5 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ONrTHIS DATE. 72-008 (Rev. 4/85) ~;-~':_~.--- Municipality of Anchorage DEFff~A~R..T,,MENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 1 4 7 10 - WAS GROUND WATER ENCOUNTERED? SITE PLAN 11- 12- 13 14 15 16 17 18 19 20 IF YES, AT WHAT O DEPTH? p E Monitoring? I ~/, . [}ate: Gross Net D~pJh to~. Net Reading Date Time Time Water .... ~.Drop PERCOLATION RATE /~. (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN'.F ' FTAND ~' 5 FT COMMENTS ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON'THIS DATE. 72-008 (Rev. 4/85) FHA Form 2573 Eorm Apploved Rev. July J95S FEDERAL HO(~SING ADMINISTRATION Budget Bureau No. 63-R296.8 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.wTO BE COMPLETED BY FHA INSURING OFFICE MORTGAGOR OR SPONSOR t~illard 14o & Carlene J. Knoppe, J~', MORTGAGEE ~ SERIAL NO., Ffr~: Nat;Lona! Bank Of Ancho~ag~e 111-0033~6-203 PROPERTY ADDRESS ~l/~peckl~ Avo,~ 350~ B DeA~un R~d anchorage, Alaska SUBDIVISION NAME TOTAL NUMBER: LIVING UNITS BEOROOM$ BASEMENT BAIHS 2 ~]Yes [~No ] New installation addnlonal bedrooms? (if Yes, how manyg) WATER SUPPLY BY~ [] Public system [] Coo]illunity system [] Individual SEWAGE DISPOSAL BY: [] Pnblic system [] Commuoity systein [] lmiividual j SYSTEM DESIGNjD FO~ ~--~ 5 ~]y o PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH {~ {{{ {~IJ_LIJ~AAJJJJJJJ~J_LI LLIJJJ~ ~ ...... II iltl -- I +H-{- III, 11,, .......... ,, IIII IIII I[11 IIII ~1 I I I I I I I I I I I I I I I I I I I I I I I I II I I I I I [ I I I.I_LJ_I.~ It is the opinion_ of the [] State [] County ~-artment of Health that this individual water-supply system ~is DOt satisfactory as a domestic water supply for the subject property. It is the opinion of the [] State [] County [] Local Department ~5,'Health that tbis individual sewage-disposal sys- tem witb proper maintea'~d'e' ~.~ ~ Can be expected satisfactorily, and ~ Cannot be expected to function satisfactorily is not likely to create an insanitary condition DATE SIGNATURE ITITLE NOTE, The healtb~/sho~ld completethe~opri~teoplnlonst.ten, ent.bove.nd.fflx d.te, sig~reondHtlelnth. spuces provided, ~ / Uso of tho ubove grid for Hoanh Department Inspector s sketch as well os uso of the back of this form is at the option of tho In~alth uuthcrlty. PART III.--~OR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoiog and the pertineDt FHA Compliance Inspection Report, and recommend that'the Individual water-supply system be considered [] Acceptable [] Not Acceptable Sewage disposal be considered [] Acceptable [] Not Acceptable. CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT DATE J SIGNATURE HEALTH AUTEIORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July 1958 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM INSURING OFFICE PART I.---TO BE COMPLETED BY FHA jMORTGAGEE First Na%~,on~l ~nk oE Anchorage 111-00,~800-203 MORTGAGOR OR SPONSOR Daml, d~r,.-Vtne ent, SUSDWISION NAME PROPERTY ADDRESS U/Specking Ave,. .3501,.,' goA'J.~r~t~u R0aCl oUN,u,.,T BILLo BLOCK NO. TOTAL NUMBER: 2J 5 BASEMENT [~] Yes J~No [] New installation additional bedrooms? (If Yes, how mcny~) WATER SUPPLY BYE [] P~ubli~c s~ys~t_e~_ .................. _C-j. _.5ommunity system SEWAGE DISPOSAL BY1 [] Public system [] Community system [] Individual r~] Individual SYSTEM DESIGNED FOR NO. OF BDRMS,[ GARBAGI~ DISPOSAt / PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT iNSPECTOR'S SKETCH It is the opinion of the [] State [] County [~Local Department of Health that this individual water-supply system [~. is ["-'J is uot satisfactory asa domestic water supply for the subject property, It is the opinion of the [] State [] County [./~.Local Department of Health that this iDdividual 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 iosanitary condition DATE , SIGNATURE TITLE _~~ '/' / l , Zx ~ / Z,? ' ~ " ~ -- sp~es provided. ' Use of the above grid for Hoalth Department Inspector's sketch as well as use of the buck of this form Is at the option of the health authority. PART III,~FOR USE OF FItA OFFICE TO THE CHIEF UNDERWRITERt I have reviewed the foregoing and the pertinent FHA CompliaDce Inspection Report, and recommeDd that'the Individual water-supply system be considered r-] Acceptable [] Not Acceptable Sewage disposal be considered [] Acceptable [] Not Acceptable. DATE SIGNATURE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATI:R SUPPLY AND SEWAGE DISPOSAL SYSTEM CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT FHA Form 2573 Rev, July 1958 'pooq~oqqgt!au u! ~tuolsno lou oa~ [] a~e '~} SllOaX Im~p!a!pul WIISA$ A1ddrl$'~131VA/~ 1VflQIAIQNI~NOIID:IdSNI .IO l~lOdltl 'satpuF qaaj a~nbs '~aaj 'SUOlle~ WIISA$1VSOdSIG-IOV/V~tS 1vrlaIAIONI~NOIJJ)ldSNI :JO ltJOdltJ 80~ 1~66 BOX U43 ANCHORAGE FAIRBAN KS PERCOLATION TEST DATA L. OCATION SKETCH L~END g~VEL ORGANIC