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HomeMy WebLinkAboutW G PIPPEL BLK 4 LT 2 S2050 I OI BlocL GAAB HD. I GRc.~.TER ANCHORAGE AREA BOROL'mH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM (:' MAILING N A M E /~ ~J~ ~' - LOCATION ~ ~, ~ ~//~ LEGAL DESCRIPTION SEPTIC TANK: . NUMBER OF DISTANCE FROM WELL ~ MATERIA[ C/~"~t~J~-~~'~+~ COMPARTMENTS /~,/~-'~/~/'~'~ -~ /~ LIQUID LIQUID CAPACITY ~ GALLONS. INSIDE LENOTM / INSIDE WIDTH ~ DEPTH_~ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS. LINING MATERIAL_ OUTSIDE DIAMETER '~ OR WIDTH ~'~ DISTANCE FROM WELL /~ NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) · LENGTH ~'~" . DEPTH ~'' , BUILDING FOUNDATION~-~uf2 ~',~-- . ~'~ ~ ~' SQ. FT.'~-' TILE DRAIN FIELD: DISTANCE FROM WELl / ,~'F~NDATION NEAREST LOT LINE_ TOTAL LENGTH · OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WELL: TYPE ~~,,/'~/~'''~-~F-'''~ DEPTH ~ DISTANCE FROM . WATER , , BUILDING FOUNDATION. ~' SAMPLE LOT LINE ¢~r~ / ~JEAREST ~/ SEPTIC ~'~;~ ~ SEEPAGE ~ . SEWER NE .TANK , SYSTEM /~, . CESSPOOl NEAREST ER ,~SO URC ES DIAGRAM OF SYSTEM DATE APPROVED HEALTH AUTHORITY GREATEIi~.ANCHORAGE AREA ~:)ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279.2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT TO SERVE THE FOLLOWING FACIL TY BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE ~S , DIAGRAM OF SYSTEM DISTANCES: 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. DA',E ¢'- ,.~0 '- ')~ A,','L,CA,TSS,G'"AT""E? ~Z5 '" ~:~ · '' GREATER ANCHORAGE AREA BOROUGH ~ ,, ,, Department of Environmental Quality 3~0 C Street, Anchorage, Alaska 99503 274-4561  __. · Date Received July ~~ Time of Inspection ~" ('~ {~~ ~ ~'~ - Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 23, 1976 2:00 p.m. 7-26-76 Monday Neale v.ao 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: Amfac Mortgage 705 West 6th Avenue, Suite 201 David A. Fahrney End Street - Box 30 Phone: 277-8588 Phone: 694-9756 3. Legal Description: S% Lot 2 Block 4 W.G. Pipple subdivision 4. Location: End Street = Box 30 5. Type of facility to be inspected Single Family 6. Well Data: Individual No. of bedrooms 3 A. Type B. Depth 175' approx. C. Construction Sewage Disposal System: A. Installed C. Septic Tank: 1. D. Seepage Pit: 1. Size Absorption Area D. Bacter ial~A~.a~l~sis On-site system~.~J~ ~ B Insta~ter ~ ~/~ 5~ 7o"--~ y ~'/.~Ma nu fac t u ret 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line Absorption area Other contamination , Sewer Lines __, B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE ..... ,~ ,.I~, ~;,: I~EPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA ~ FHA. .CONV Ma,,ng Address: 3. Nameof Buyer: ~' \ M ail in g Ad d ress:~>,C2~ ,"~e,y. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Mailing Address:. Legal Description: Location: ~--~. Phone: Type of Facility to be Inspected: Water Supply Type of Supply: Public UtiLity No. Bdrms. Individual ~ If Individual, number of dwellings presently served If Individual, depth of well ~.'~ Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation 72-oo3(3/7a) Page 2 of two pages - Re~.~,~t for Approval of Individual [._~er & Water Facilities Legal-Descript{on S½ Lot 2 Block 4 W.G. Pipple Subdivision Comments Approved ~~isapproved Date ~/~///~ Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 ~ ~ Date Received --~ ~ b[~_'}~- Time of Inspection ~'. ~..~ ~iN~D~i~AQ~ iiii ii iEispection 1. Approval requested by: Mailing Address:(~b~ ~ 0 <~<~ Phone: 2. Property Owner: ~_~ ~ ~(~"x,~ Phone: Mailing Address:-- _ ~ A 0~~~ a. ~:~ , . 3. Legal Description; ~'lr~. ~ ~.; ~ ~J~,. kak~, ~. 4. Location: t~_~x ~ e~ ~'~~ ~ 5. Type of facility to be inspected ~ ~-- ~ No. of bedrooms 6. Well Data: A. Type ~. B. Depth C. Construction D. Bacterial Analysis Sewage Disposal System: A. Installed <:~-~'~,C~- ~ 0 B. Installer N,~3c~ C. Septic Tank: 1. Size F'~?m(~ 2. Manufacturer D. Seepage Pit: 1. Absorption Area 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 ~Q-034 (1/74) Page 1 of two pages GREATER ANCtIORAGE AREA BOROUGH Department of Environmentaq Quality ' 3330 "C" st,, Anchorage, Alaska 99503 274-4561 REQUEST FOR APPROVAL OF . , INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: 2. Property Owner: Mai-ling Address: 3. Name of Buyer: Mailing Address: CMRO VA ~ FHA CONV Name of Lending Institution: ~ o Name of Realtor or,Agent: ~q~ ~V~ ~k~~ 6. Legal Desqription: Location~, 7.' Type of Facility to be inspected: 8. Water Supply go Type of Supply: Public Utility Individual If Individual, number of dwellimgs presently served If Individual, depth of well N~;D~._~ ~[], 'sewage Disposal System jType of System: Public Utility \ If ~ndividual,. date of installation Individual (on-site) ~<. Eq-O37 (1/74) .P~e 2 of two pages - Reqk.~ for Approval of Individual S~_.~,& Water Facilities Legal Description ~'/~- ~'~-- Comments Approved Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ,034 (1/7~) To Whom it May Concern, I personally installed the septic system on the South ~ of Lot 2, Block 4, W.G.Pippel Subdivision~ Eagle River, Alaska. It was a borough approved system installed in 1970 and to the best of my knowledge was a 1,000 gallon septic tank. September 23, 197~ , , ~/ ~ INDIVIDUAL SEWAGE AND ~i;AT~R FACILITIES 5. ~a~e~ysis: a. Bacte~i~ul b. Detergent. Wel 1 data: b, Dept~ ..... .. ~ , ,.. Casing Size Distance from well to closest existing or proposed: 1. Sewer line ~ 2. Septic tank -~-/. . ~ 3. Seepage &rea /O.~/. ~~q ~ ~ 4. Cesspool~ -~ 5. Property Line, 6. Other sources of p. ossible, contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. .-- · i~/~./~%~/_1 Sewag~ disposal system. ~ ~.~ , ~,, b. Septic tank capacity in gallons. . '/~ ~ . c. Name of septic tank manufactu~m '~ ~'~ 1. If "home made" show diaqram on reverse side of this form. Disposal ~el~ or seepage ~t size and t~, //,.~/~-~-- ~. : 1, Distance t to house ' foundatlon~J Per¢olat~o~ Te'sd: 're.su3-ts f, Percolation Test performed by , · se the ~everse .side of this form to sho diagram. Diagram should include ...f~he foilowing information: ~operty lines;.well location~ house location~ · ~p~£c tank location, disposal area location, location of percolation test, a~..di~eetion of ground slope. 9. The ~for~ation .on this form is true and correct to the best of my knowledge· Signature of Appl~ic~nt ..... Sig d Date ne TO BE FILLED OUT BY HEALTH DEPART!.!ENT PERSONNEL ~--~e above described ~anitary facilities are hereby approved, subject to the ........ · ~l~owing con~ons: Conditions: ~'The above described sanitary facilities are disapproved for the following '-'--ApproVal is valid for one year following the date of approval. ~ CPJ:cw REQUEST FOR APPROVAL OF INDIVIDUAL SENAGE AND WATER FACILITIES prope~y~ owner 3. La~.a~. daa~iptioa. .S1/2 of Lot 2~ Block $, Walter Go ~ipple. Sub. Number ~of. ]~edmooms in house 2 5. Wate~ Analysis: a. Bactemial b. Detergent 6. Well data: a. Type,, Drilled b. Depth.,, 85 ft c. Casing Size Distance from well to closest existing or proposed: 1. Sewer line 2. Septic tank..,145 ft 3. Seepage Area 4, Cesspool' 150 ft 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 Aug .67 b. Septic tank capacity in galionsl,000 c. Name of septic tank manufactum~,r Tuck Cons% 1. If "home made" show diagram on reverse side of this form. Disposal field or seepage pit size and type __ 8' 8' 8' log crib 1. Distance to property, line 20 ft to house oundatzonOm £t h · e, Percolatic~ Te~t ~r~sults f. Percolation Test performed by Use the reverse ,side of this form to show diagram. Diagram should include [~he foilowlng information: ppoperty lines~.well location, house location~ ~ptic tank location, disposal area location,, location .of percolation test~ gad direction of ground slope. The i~-fox~ation on this form is true and correct to the best of my knowledge. S~gnature of Appilcant Date signed TO BE FILLED OUT BY HEALTH DEPARTMENT PERSONNEL ~The[ above described sanitary facilities are hereby approved, subject to the .......... ~l!owing cond~onsi Conditions: The above described sanitary facilities are disapproved for the following ' Signature of ~fficf~12 ' ". ~' .:. ~at'e -m-: [~, :,~.~ Approval is valid fort one year following the date of approval. CPJ:cw HEALTH AUTHORITY APPROVAL IHDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. MATANUSKA VAL~SBY BANK M~TANUSgA VALLBY BANK MORTGAGOR OR SPONSOR PROPERTY ADDRESS S~ Lo~ 2~ Blk 4, W. G. Pippel Sub. LBSSBL Do LOFGRBN and BBRNADB~CB LOFGRBN Bagle River, Alaska SUBDIVISION NAME BLOCK NO. LOT NO. 3. Wu G. PIPPBL SUBDIVISION 4 2 S~ 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 [] 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 DATE SIGNATURE TITLE NOTE: The health au~thor!ty should complete the appropriate opinion statement above and affix date, signature and title tn the spaces provided. ~ · ~ Use of the above grid for Health Department Inspector's sketch as well as use of the back of this form is at the option of the health authority. 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 AUTflORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM ] CHIEF ARCHITECT ]DEPUTY FOR CHIEF ARCHITECT FHA Form 2573 Rev. July 1958 REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY TREATMENT consists of [] Septic tank. [] Cesspool. Septic Tank~ Distance from well,__ Total liquid capacity,. Inside length,. Distance from: Well, Inside diameter, feet. Material, Number of compartments , gallons. Capacity inlet compartment, .gallons. feet. Inside width,, feet. Liquid depth, feet. feet; foundation, feet. Depth,~ SECONDARY TREATMENT consists of [] Tile disposal field. Tile Disposal Flold: Distance from: Well,_ Total length of tile lines, Trench width, Length of each line, Type of filter material: [] Gravel. feet; ncaaest lot line at [] front, [] side, [] rear, feet. Liquid capacity, gallons. Lining material [] Seepage pits. Other feet. Date of inspection__. feet; foundation feet; nearest lot line at [] front, [] side, [] rear,. feet. Number of lines. Distance between lines, inches. Total effective absorption area in bottom of trenches, feet. Depth, top of tile to finish grade, [] Broken stone. Other feet. square feet. .inches. Depth of filter material beneath tileq inches. Seopage Plts~ Number of pits , Outside diameter, .feet. Depth, .feet. Lining material Distance from: Well, feet; building foundation, feet; nearest lot line at [] front, [] side, [] rear. Inspectlen mode byl [] State. [] County. [] Local Health Authority, Inspected by , 19 Depth of filter material over tile, feet. REPORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM Distance to nearest public water main, feet. Size of main, inches. Individual wells [] are [] are not customary in neighborhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborhood [] are [] are not being developed with both individual water-supply and sewage-disposal systems. Lot size: feet wide,, feet deep. Dwelling set back from front property line,, feet. Individual water supply from: [] Drilled well. [] Driven well. [] Dug well, [] Bored well. Distance of well froml Building foundation, cast iron sewer,. seepage pit, Well construction: .feet; tile sewer, feet; cesspool,_ feet; nearest lot line at [] front, [] side, [] rear,. feet; septic tank, -feet; disposal field,. feet; other sources of possible pollution, feet. Diameter, inches. Total depth, feet. Type of casing, Approximate depth to pumping level of water in well, feet. Approximate yield, Sealed watertight to depth of feet. Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill. Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No. Pumpl [] Shallow well. [] Deep well. Length of drop pipe, feet. Pump capacity, Located in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit. Pumproom properly drained: [] Yes. [] No, Pump mounting watertight: [] Yes. [] No. Type of storage: [] Pressure. [] Gravity. Capacity, gallons. Has bacteriological examination of water been made? [] Yes. [] No. If answer is "yes," give date Quality of water [] is [] is not satisfactory for human consumption. Installation [] does [] does not comply with approved exhibits, if any. Inspection made by: [] State. [] County. [] Local Health Authority. Inspected by Date of inspection ., 19 Depth of casing, _gallons per minute. gallons per minute. 19 feet, .feet; feec.