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HomeMy WebLinkAboutTIMBERLANE PARK #1 BLK 2 LT 7 E2TIME TIME T!ME " DATE DATE DATE ~NSPECTOR ~NSP~CTOR ~NSPECTOR ANCHORAGE MUNIC pALIIY OF AN~H~RAG~  825 L Street - Anchorage, Alaska ggs01 ~NVI~oNME, ~ ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not he,recessed. Please allow ten (10) days for processing. PROPERTY RESIDENT (If different from above) PHONE 2, BUYER PHONE MAI LING ADDR ESS 3. LENDING INSTITUTION ] PHONE 4, REALTOR/AGENT ~ PHONE MAILING ADDRESS 5, LEGAL DESCRIPTION STR'E ET LOCATION / 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four [] SINGLE FAMILY [] 'Two [] Five ~] MULTIPLE FAMILY [] Three [~ Six 7. WATER SUPPLY INDIVIDUAL* COMMUNITY [] PUBLIC UTI LITY [] Other * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-SITE** /~'7 / YEAR ON-SITE SYSTEM WAS INSTALLED. E] PUBLIC UTILITY /q~ ..,.~M~._. ./OraTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. '"i' THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FiVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [~] INDiVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding -rank Size:~ ~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA --MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line / -f [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) I~]-~"DISAPPROV ED DATE BY 72-010 (Rev. 6/79) 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF I]EALTH AND ENVIRONMENTAL PROTECTION May 16, 1980 Darrell S./Sally L. Robinson Star Route A Box 190 Anchorage, Alaska 99507 Subject: E½ Lot 7 Block 2 Timberlane Park Subdivision Approval for your individual sewer and water facilities can not be granted until the following items have been completed: (1) The sewer system was installed without a permit from this department. One will need to be issued. (2) (3) Prior to the permit being issued, a soils test will need to be obtained. A list of private firms who perform soils test is enclosed. An adequacy test be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this department for our review. (4) The septic tank pumped with a receipt submitted to this department. Please have the total number of gallons pumped from the tank on the receipt. This is to verify the size of the septic tank. 'DaYrell S./Sally L. May 16, 1980 Page Two Robinson (5) Your sewer system and your neighbor's sewer system is too close ko your well for it to qualify for a duplex. Your request may be changed to a single family dwelling or; left at a multiple family dwelling if the following is accomplished: Move your leaching area 120 feet from your well and your neighbor's leaching area is moved 120 feet from your well. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw /~ ~--~MUNICIPALITY OF ANCHORAGE~-~ ~?~. ' DEPARIMEI )OF HEALTH AND ENVIRONMEN{ ./ PROTECT[ON -fi~-'~2e.q~b~ ~9~qq 0~%~ ~O~e Eeceived: November 28, - LxG~ ~ J~- ~>,i~ ~- ~l: Time ~iLl~.a~ ~2: Time #3: 'rime Date _~_ ~ S~I~ Date Dahe Insp ~~___ '} Insp Insp 1977 3 o REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AN[) WATER FACILITIES Lending Institution Request: Security National Bank % Fran Agut__ Mailing Address: Propeity Owner: Mailing Address: Pouch 7-777 99510 Darrell/Sally Robinson Star Route A Box 190 99507 Phone: Phone: 276-6800 278-9579/W him 344-3441/h Legal Description: E½ Lot 7 Block 2 Timberlane Park Subdivision Single Family Residence: (x) Multiple ~am~._y Residence: (xg Number of Bedrooms: Number of Bedrooms: Seven Well System: Permit % Construction Individual well (x) Conmmnity/Pub!ic System ( ) Depth of Well 81' Well Log on FJ_le Bacterial Analysis ( ) Sewage Disposal System: Permit # Septic Tank Size Absorption Area On-site System (x) Public UtJ. lity Installed 1970 Installer Man uz actur er Soils Rate Material ( ) Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTF. CTION 2 8 1977 RECEIVED I. Type of Inspection: CMRO. VA 2. Property Owner: Darrell & Sally ROBINSON Mailing Address: SPA Bo× 190, Anch, 99502 3. Name of Buyer: FHA CONY ××× 278-9579 office DayPhone:344-3441 home Just placed on market, not sold yet husband) Mailing Address: Day Phone: Name of Lending Institution: Security National Bank Mailing Address: Pouch 7-777, Anch, 99510 Phone: 276-6800 5. Name of Realtor or Agent: None Mailing Address: Phone:. Legal Description: East ½ of Lot 7, Block 2, Timberlane Park Location: 1¼ mile South Klatt Road (off old Seward) 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Residence-duplex No. Bdrms. 7 Public Utility ,Individual XXX If Individual, number of dwellings presently served If Individual, depth of well 81 ' Sewage Disposal System Type of System: Public Utility 1 dwelling that has 2 units Individual (on-site) ×X If Individual, date of installation 197 0 Please return to: Security National Bank Pouch 7-777 Anchorage, AK 99510 Attn: Fran Agut 72 003(3/76) page $' ~ Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: E½ Lot 7 Block 2 Timberlane Park Subdivision Con~nent s: Affadavit Attached: ( ) Letter Attached: ) Approved: Disapproved: Date: 'Department Worksheet: Deceraber 13, 1977 Darrell Robinson Star Route A BOX 190 Anchorage, Alaska 99507 Subject: E½ Lot 7 Block 2 Ti~bsrlan~ Park S~b~ivision This depaz'tment does not have any record of a sewer system on the above subject lot. After checking theeexisting seepage pit~ it was noted that the crib was full~ and after talking to ~xs. Robinson she informed me that pumping was necessary. Th~ef°re, before we may approve your requeS~ for sewer and water appreVei, the follOWing must be Completed. (1) ExPose the septic tank and have it pumped to verify its s~and existence. If it is not a 1,750 gallon tank~ then you will need to add another tank onto the existing tank. (2) Obtain a soils test, see handout, so that a permit fo~ upgrade may be issued by this department. ~.~nies may be escrowed ~o that the project can be completed at a later date. Temporary approval can be granted on this basis, if the upgaade is completed by June 30, 1978. If there a~-e any further questions, please contact this office at 264-4720. Sincerely, ~' Robert C. Pratt, Sanitarian RCP/lJh Security National Bank % Fran Ag~t [~[!Ci~PT FOP~ ~WP,'i'IFi~} IVlAIL~3~0( (plus SENT TO ~i0., ST-ATE ~Ng Zll~cOD~ OI'Y O~IAI. SEflVJ~E~FO~ODITIO/IAL Apr. 19'/] J~O] fo~ IiIT[RIIATIO AL MAIL postag~e) POSTMARK OR DAT~ (See other side) DATE AD..,? DEP~ARTMENT OF HEALTH AND SOCIAL [~ ,ICES DIVISION OF PUBLIC HEALTH :'-: ~ INDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGICAL WATER ANALYSIS INDIVIDUAL ~_ SEMI-PUBLIC [] CHLORINE RESIDUAL PPM REPORT RESULTS TO ADDRESS CITY '~..r - ZiP CODE ADDRESS ~OE SOURCE ~ Lab No. OFFICE Analysis shows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactory [] Questionable [] Sample too long in transit;-sample ~hould not be over 48 hours old at exam~nallon fo indlcate reliable results. Please send new sample. [] Bottle broken in transit, please send new sample. S.~,NITARIAN'S REMARKS COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY gATE COLLECTED TIMR COLLECTED r ' '~ ' Sample Collected Fram ~] Kitchen Tap [] ~alhroom Tao [] Basement Tap [] Other (List] Well- [] Dug [] Driven · Drilled [] Bored SOURCE: [] Spring [] Cistern [] Other__ Dug Well or Cistern Conslructlom Walls- [] Wood [] Concrele ~] Meta ~ Tile Brick ~r DISTANCE TO: or Other Drainage Pipe Feel. Tile Seepage Cess- Other Possible ~ Plastic Joint Material - Type GENERAL: Does Waler Become Muddy or Discolored? ~ Yes ~ ~o When? Diameter of Well Deplh Feet. Well Casing Material Diameter Depth _ Length al Water Depth Drop Pipe -- From Bottom Feet, Offset Jn In utigw PURPOSE OP EXAMINATION: Illness Suspected? READ INSTRUCTIONS ON REVERSE SIDE ~..- BEFORE COLLECTING SAMPLE [] Yes [] No Repairs to Syslem? [] Yes [] No S;gnaTure B6-1220 Ib) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1973 Date Received / Z'-- ! ~' /// ?[me Received pm Lab. Lactose Broth j 1Oct 10c¢ lOcc 1Oct 1Otc 1.0cc i.Occ 24 Hours ~ Lactose Broth, 24 hrs. Coliform Density MF Results Reported by Phis analysis indicates Coliform Organism 48 hrs, [Most probable No. per 100cc) 4. 5. ' ~ ~= AREA GREATBR ~N~,'IOR~=~ BOROUGH Department of Environmental Que!ity 3500 Tufter Road, Anchorage, A].aska 99507 2:19-8686 T~me of Insoectlon /~: ~ REQ.,EST FOR APcROVAL OF INDIVIDUAl. SEi~tER g WATER FACILITIES FOR 6. Welt Data: C, Constructionist. . ~fa~ ovstem. 7. Sewage Disoosel ~. · Depth Instal ] er C. Septic Tank: 1. D. Seepage Pit: 1. E. Disposal Field: Size~_j~-~_ 2. Manufacturer , . Size 2. Material Total Length of Lines Distances: A. Well To: · -, · Area_~/.__~_/ , Sewer Lines Septic Tar, k_.__~Z_%/_~., Abso_otzon ~ , Neeresi: Lot I..ine__% (~ -~ Other Contamination B. Foundation to Septic Tank ']. AbSorption Area C. Absorption Ares to Nearest Lot Line R~quest for A,oproval of I;~'"-'-?idual Sewer & Water Fac~litie~-~- ~Pag~Two Aporova] Valid for One Year Ftcom Date Signed Greater Anchorage Area Borough, DeFaYtment 'c,f ~nvi'~on~.enta] Quality I certify that the information contained in this request for approval to be a true and accurate representers]on of the sub.iect sewer and water facilities located at: Signed Date STATE of ALASKA TO: F Lynn S. Coad Greater Anchorage Area Borough Department of Environmental' Quality 3500 Tudor Road Ancho~age~ Ak. FROM: Sylvia M. Cowan-~' Social Worker III DATE SUBJECT: June 28, 1972 Please sample the water well and cesspool at the following residence: Darrell & Sally Robinson Star Route A Box 190 Anchorage, Alaska 99502 Telephone: 344-3441 Drive south on the old Seward Hwy. Turn right onto Klatt Road. In approximately one mile, the road curves twice. The house, red and. green, is the third house after th~se:curves. smc D£P['"~UEflT OF HEALTH Arid SOCIAL SE'-'~CES DIVISION OF PUBLIC HEALTH BACTERIOLOGICAl-~WATER AflALYS~S READ. INSTRUCTIONS, ON REVERSE SIDE BEFORE COLLECTING, SAMPLE' OFFICE 4; If ~ter cheeMng eq~pment a 8/sinf. ~tMg zesidu~l. ~ not ob?fined, plebe [] drilled we~l ~ dstem ANITARIAN'S REMARKS 06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD APPROVAL ADDRESS: GREATER ANCHORAGE~ AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: INSPECT: TIME: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR 1¢ - 5- 7/ REQUESTED BY: PHONE: 2 PROPERTY OWNER: ~ /¢~d C'~'~ ,,',/&/~.,~¥ PHONE: 4. TYPE FACILITY TO BE INSPECTED: ~¢?/~ STREET: BEBROOMS: ~ o NUMBER OF WELL DATA: B. DEPTH C. SIZE D. CONSTRUCTION E. BACTERIAL ANALYSIS SEWAGE DISPOSAL SYSTEM: A. SEPTIC TANK INSTALLER (IF HOMEMADE, SHOW DIAGRAM ON BAC:~/pmo/7 , APPROVAL REQUEST FOR SEWER PAGE TWO & WATER FACILITIES 7, B. SEEPAGE PIT 1. SIZE 2. LINING C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK B. WELL TO SEEPAGE PIT SEWER LINE PROPERTY LINE C. WELL TO D. WELL TO E. WELL TO OTHER F. FOUNDATION TO G. FOUNDATION TO H. SEEPAGE COMMENTS: POSSIBLE CONTAMINATION SEPTIC TANK SEEPAGE PIT PIT TO PROPERTY LINE APPROVED: ~-,/--~--z-~ ISAPPROVED: DATE: DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY HEALTH AUTHORaTY APPROVAL aNDIVIDUAL W. ATI~R SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA SERIAL NO. [~] Yes INSURING OFFICE MORTGAGEE V~teve_nFn ~inistratimL National Bank of Alaska MORTGAGOR OR SPONSOR PROPERTY ADDRESS Ja~s Aaron Wills Jr., and Lfnda g. Wills glatt Road SUBDIVISION NAME TOTAL NUMBER, j J~] BASEMENT Yes ~ No WATER SUPPLY BY: ~ Public system ~ Communi. system ~ Individual SEWAGE DISPOSAL ] New installation 174244 BLOCK NO. LOT NO. ~ E. 112 7 additional bedrooms? (If Yes, how many~) SYSTEM DESIGNED FOR s l Yes rlEALTH DEPARTMENT INSPECTOR'S SKETCH I1[11111 IIIIIII IIIIII Il[ill II Illlllllllllllllllllll III IIIIII ~111 III I JJllllll IIIIIII tllllilllJ,,lli,lllllllil IIII,, Ill I [ I l[lil I Il I I ,l llllllll Il lllIIl illI I,,,, I llllll III::I [[':[l'''''::~[[::ll:lll Il llllllll[lll ,11,, "" '"" "'"' '""1 "' II iiI Il lJllllllJlllllllllll llllll IIII llllll 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 rem with proper maintenance: [~] Can be expected to function satisfactorily, and is not likely to create an insanitary condition [--~ Local Department of Health that this individual sewage-disposal sys- --]Cannot be expected to function satisfactorily DATE . SIGNATURE TITLE PART Ill.--FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: 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 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM ] CHIEF ARCHITECT ] DEPUTY FOR CHIEF ARCHITECT FHA Form 25/~ Rev, July 1958 INDIVIDUAL SEWAGE ~,, ,~ Name ,of person 2.~N~Ine· of prope~y: owner 3. Lega~ 4. Number-ot},~bedrooms in house Wate~x_Analy~ is. a. Bac~teria& b. Detergen~ .... b. Depth c. Casing Size d.:, ~istance fro~ well to closest existing or p~oposed: 2. Septic tank ~.~ 3. ':~eep~age Area · 4. oo1' 7e 6. Other sources of possible contamination, i.e.~ creeks, lakes, houses, '~a~n, drainage ditch, etc. , , .,. Se~rag~ disposal system. a. Age of system . · ,¢. b. Septic tank capacity in gallons c. Name of septic tank manufactu~ . __ 1. If "home made" show dza~ram on reverse~zde of this' form~ d.' Disposal field or seepage pit size~nd t. Di~ance to p~ope~-~ne ~0 ~ to h~use fo~dat~on ~00 e, Percol~tio~Te~th-esults . Percolation Test performed by ..... . se the reyerse,side of this form to show diagram. Diagra~ should include he ~oilow~ng, information: p~operty lines;.wgll location, house locatzon, ~ptzc tank location, dzsposal area location, location of percolatzon test, a~, direction of ground slope. The l~o~mation on this form is true and correct to the best of my knowledge. ~Signature of Applicant TO BE FILLED OUT BY HEALTH DEPART~ENT PERSONNEL Date Szgned ~e above described sanitary facilities are hereby approved, subject ~o the ......... ~l~owing cond~ions: " Conditions: The above described sanitary facilities are disapproved for the following reasons: ...... ~ ,.~ , ~.:~L/~+L ~:A/~,C~/~ ~ , A v ' '-- ~' ' .... p~ a~ zs valid fo~' one year following the ~te of approval, CPJ: cw ADHW. ~B-2W STATE OF ALASKA D~"~RTMENT OF HEALTH AND WEI?'~E DIVISION OF PUBLIC HEALTH BACTERIOLOGICAL WATER ANALYSIS REPORT RESULTS TO ADDRESS SAMPLE COLLECTED BY ' ' DATE COLLECTED ' . .' - ' '~' TIME COLLECTED MATERIAL: Build[nB Sewer - [] ~e°Snt 0 Woo~ 0 Tile 0 Fibre 0 Asbesfo~ When? OJameler of Well Depth Feel. Well Casing 0 Of Well [] OIhel PURPOSE OF EXAMINATION: illness Suspected? [] Yes [] No OFFICE Records in this office indJcole this WATER SUPPLY to be of: Satls[aclory 0 Questionable 0 UnsalJsfaclary SanUary Stalul Analysis shows fhls Waler SAMPLE fo be: Satisfactory 0 Questionable [] Unsalidaclory. If an "Unsafisfaclory" or "Questionable" status is indicated above you should lake immediate acBon as recommended below, 1. Holily consumers water B ao]luled. Bail or chemically 2. Increase chlorination sufhcJenll¥ l¢ meal recommended residual slandards Delermine source d coalamlnaflon and take action necessary ~o maJnlai~ a safe waler supply at oil times. R. Check chlori~afio~ and other mechanical equipment. Make cerlain it is lundionlng properly. 4. If abet checking ecjulpmenl a dlslnlecling resldual'is hal obtained, please wire IhJs bffice lot e'mergency c~sslslaace oi' advisory servicet S. Thls is a surface water source and subiecl fo pOII,)fion by man and anlmaL__ - An approved water suppl'/ source should be developea. 6. Improve your [] spring [] dug well [] drlven well [] drilled well [] cistern. 7. Relocate your well to a safe 1aeolian in relafionshla to your sewage disposal syslem. [] see enclosure 8. Sample too long in translt: sample should not be over 48 hours old at examination Ia indkole reBable results, please send new samole [.7 Bo"le Broken in transit, please send new sample. 9. Contact your nearest [] Loca~ HeaUh Deoarlment or [] Alaska Division of Public Health. sanitation olflce for bulleBn~ consuBallon and SANITARIAN'S REMARKS Signalure READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD am Date Recelved Time Received pm Ldb. No. Lactose Broth T0cc 10cc 10cc 10cc J 10cc 1.0cc 0.1cc 24 hours 48 hours · · BrJllionl Green 24 hours 48 hours EMB AGAR Ladose groth. 24 hrs 48 hrs.- Groin's stain Coliform Dens ly {Mo~I p~'obbbJe No. pe~ J0Oc¢.l MF resulls am Dm Date Reported by This analysis indkafes Colilorm Orgamsms to be; Absent 0