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Home My WebLink AboutVANS Block 2 Lot 1L INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM Name· /v/~' I~ttw.~t~/ . Mailing Address .1 Location ,,, ~. ~,~ I~Legal Description SEPTIC TANK: Distance from well.~/7'..,.Matemial ~ i Number of compartments SEEPAGE SYSTE~_: Seepage Pit: Nu~eP of pits ~ Outside dla~e~ width , length. , depth , lining matemial . Dist~ce ~om well ~7 ~ , building fo~dation ~ ~ . , nearest lot line~.; To~al effective absorption a~ea (wall a~ea), sq. ft. ~;S~/~ ~ TILE DRAIN FIELD: Distance from well.. , fo~da~ion . ., nearest lo~ line Total len~h of lin~.. Nu~e~ of lines Distance between lines T~ench width~ in. To~al effective absomption area sq. ft. Length of each line Depth: Top of tile to finish gmade . Depth of fil~ev maTevial beneath tile in. Above ~ile WELL: Type~llle~, depth ~l~I · distance ~om building fo~dation 3.~' ~., neavest lo~ lxne~C ~ neavest sewe~ line.q~ ~ septic tank ~ 7 i . ~ , seepage system ~ ..~ DIAGRAM OF..SYSTEM. DATE: I ~Health Authorzty S~""-'GE DISPOSAL SYSTEM - APPLICATI~~ '~ PERMIT Mama of.~Applicant ~ ~3~0~ Mailing Addx~ss ~/~ Application to Install: Septic t~k,,,,,~,, Seepage p&t , D~ain field__- TO Serve the ~pllowlng Facility ,~ 8~0~ ~d~ ...... Financed Through.. ~ ~ To ~e Installed 5y ~CCgF Pemcolation Test Results_ ~tic'pated Date of BELOW TO BE FILLED OUT BY HEALTH DEPART~NT This is to serve as~ ~d/~j~3' , permi~ to install a /~O ~n t ~s described below. Size of ~it to be served_ ~ ' Z/~ ~ Type ....... · ~ptic tank S~ze ~2 ()Type epage ~ea~ DISTANCES: Health Authority D~AGRAM OF Sy. STEM I certify that I am familiar 'with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. FHA Form 2573 Rev, Jub' 1958 I U, S, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL HOUSING ADMINISTRATION HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA SERIAL NO. INSURING OFFICE MORTGAGEE MORTGAGOR OR SPONSOR V~ ~ ~ PROPERTY ADDRESS SUBDIVISION NAME /,,..,~e, ho~.~ ~ EtOCK NO. 2 LOT NO. TOTAl. NUMBERz WATER SUPPLY BY: [] Public system SEWAGE DISPOSAL BYE [] Public system BASEMENT J [] New installation []Yes [--1No r--] Community system ]Community system additional bedroomsT (If Yes, how manyf) YSTEM DESIGNED FOR [~Individua[ [] Yes J~,No PART lB.--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 [] 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 ~-.~TE J SIGNATURE 1T'TLE NOTE: The health authori~ should, complete the opproprldte opinion statement above and affix date, signature mhd title In the spaces provided. Use of the above grid Jar Health Department Inspector's sketch as well as use of the back of this form is at the option of the heal~ authority. PART Ill.--FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Complial~ce 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 Farm NUISANCE COMPLAINT FORM Phon9 No~Z2~[~Z~J Box No, · v~ of Person ' ~; ~ ~F/ Owner's Add~ess: Ph2ne ~o~' ~ ' Street Address: Pemson Receiving Complaint: Date: ~ ~ I certify that such statement of facts is true to the best of my belief and know- ledge. I mequest that the fomegoing matter be investigated and that appmopriate action thereafter be taken, I am willing to testify to the facts stated in the foregoing complaint in coumt if necessary. REPORT OF ACTION TAKEN DATE COMPLAINANT WAS CALLED REGARDING DISPOSITION OF COMPLAINT: DEPARFMFNT ~" IICALT AHD [NVIRONNEII'TAL PROTI[CTION PLATTING OR PLANNING AND ZONING CAgE REVIEW CASE NUMB£R S-4188 PETITI 3,1 FOR Date leceived Rezoni ng Special Exception VACATION RESUBDIVIS ION COmll~en~ to Plallniil~ Dy OF Van's Sub for meeting of of Cases COMMENTS: ENVIRON_MENT L _SAN_I._T__A~_T_ION: _P_UB_L. IC IZATER~y~ILQLE. PUBLIC SEWE~'~AVAILABLE TO SERVICE ENVIRONMENTAL ENGINEER: NG: FHA REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES (Fill out in Triplicate) Name .of person requesting approval, Robinson & Parr 2." Name of proper~y:owner ...... same 3. Legal descriptioR l.ot 1_ Blk 2. Van $~bdiyision 4. Number-o~edrooms in house 3 5. Watem~Analysis: a. Bacteria~ b~ Detergent_. 6. Well data: a. Type~led --, .b. Depth 128' c. Casing Size d. Distance from well to closest existing or proposed: 1. Sewer line 2. Septic tank 3. Seepage Area ..... 97' 4. Cesspool',. 5. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn~ drainage ditch, etc. 7. Sewage disposal system. a. Age of system new b. Septic tank capacity in gallons 1000 gallons c. Name of septic tank manufectum~r 1. If "home made" show diagram on reverse side of this form. d.' Disposal field o~ seepage pit size and type log crib 8x~x6 1. Distance to proper~y line 25' to house foundation 36~ .e. Per¢ol~tion~Tt~st~resu135s~ ............ . f. Percolation Test performed by Use the reverse.side of this form to show diagram, Diagram should include '~he fo~.owir~g information: ~operty lines~.well location, house location, '~'~¢ tank location, disposal area location, location of percolation test, arq di~ection of ground slope. The ~T~t~on on tkis form is true and correct to the best of my knowledge. ON FILE AT HEALTH CENTER 11-7-~ . ~ S~gnature Of Applicant Date Signed TO BE FILLED O[!T BY HEALTH DEPARTMENT PERSONNEL ~T~e above described uanltary facilities are hereby approved, subject to the .......... ~l~owing con~ons: Conditions: NONE The above described sanitary facilities are disapproved for the following David B. Harkness, Sanitarian Approval is valid for on~ year f0110win~ th~ da~ o£ approval. CPJ:cw v // INDIVIDUAL SEWAGE AND WATER FACILITIES // (Fill out in Triplicate) 2. ' ~tame of property: owner 4. Number--o~ bedrooms in house "3 5. Wate~.Analysls: a. Bacterial b. Detergent '" ' c. Casing Size d. Distance from well to closest existing or proposed: 1. Sewer line 2. Septic tank 4. Cesspool' 5. Property Line Other sources of possible contamination~ i.e., creeks, lakes, houses, barn, drainage ditch, etc. Sewage disposal system. b. Septic~tank capacity in gallons c. Name of septic tank manufacturer 1. If "home made" show diagram on reverse side of this form. Disposal field~o~ seepage pit size and type 10 Distance to~property line ~ to house foundation -e, Percolati~ T~st ~results ,. f. Percolation Test performed by Use the reverse ,side of this form to show diagram. Diagram should include '~'~he following information: p~operty lines~Well location, house location, ~.eq~tic tank location, disposal area location~ location of percolation test, an~ direction of ground slope, The intoxication on · this form is trus and correct to the best of my k~owledge S~gnaYure of Applicant ' ~a~e ~$ig~e \ T_0 BE FILLED OUT BY HEALTH DEPART~,~ENT PERSONNEL ~The above described sanitary facilities are hereby approved, subject to the ......... ~61!owing cond~ions i ' ' A The above described sanitary facilities are disapproved for the following reasons: Approval is valid for one year following the date of approval. CPJ:cw