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