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HomeMy WebLinkAboutWALTER G PIPPEL ADDITION BLK 5 LT 85 Gl {TER ANCHORAGE AREA BOROrI"'~H ~ , HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 2~-2511 · INSPECTION REPORT ON-SITE SEWAGE DISPOSAI~ SYSTEM SEPTIC TANK: ADDRESS PHONE. DISTANCE FROM WELL ~ MATERIAL ~'~"~r~/' .COMPARTMENTs.NUMBER OF I LIQUID CAPACITY fi~)~' GALLONS. I~SIDE LENGIH INSIDE WIDTH DEPTH_ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS ~ OUTSIDE DIAMETER t/~ 4r OR WIDTH I~ LENGTH / ~ DEPTH LINING MATERIAL (~O ~ DISTANCE FROM WELL /~'~)" BUILDING FOUNDATION NEAREST LOT LINE ~/~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL , FOUNDATION , NEAREST LOT LINE , OF LINTel. ., ABSORPIIOIx~R~, ~~' SQ. FI. LENGTH O-~EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE J~;//~ ~ DISTANCE FROM ~.i~ WATER ~ WELL: TYPE . DEPTH ,BUILDING FOUNDATION SAMPLE , NEAREST NEAREST SEPTIC ~ SEEPAGE ~ LOT LINE ~ ., SEWER LINE TANK ~d"(~ SYSTEM ~r OTHER ..... =' , ,CESSPOOL ~' , SOURCES DATE DIAGRAM OF SYSTEM t APPROVED~~/~~ HEALTH AUTHOrlIY /~T~X J>~, MUNICIPALITY OF ANCHORAGE /~'~X DEPARTM~" ' OF HEALTH AND ENVIRONMEN, ~L ((k~9~ ~t[_l_ S2,5%~/L ' Street, Anchorage, Ala~ Date Insp Time Date Insp PROTECTION 99501 May 5, Time Date Insp 1977 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Alaska'National Bank of the North Mailing Address: Pouch 7'010 99510 Phone: 278-4581 Property Owner: David/Betty Raulerson Mailing Address: Phone: 694-9185 3. Legal Description: Lot 10A Block 5 Walter Pipple Subdivision 4: 3 Single Family Residence: ( Multip!e Family Residence: Number of Bedrooms: Number of Bedrooms: Well System: Permit # Construction Individual Well ~ ) Con,nun,s.y/Public System Dis ~ances: Well %0 Sewer Line Septic Tank Size _j ~~Manufacturer Absorption Area ~ ~7~.~ Rate . to Septic Tank ~j~_ ~ Nearest Lot line -- / to Nearest Lot.Line Material to Absorption Area --~O/~bsorption Area · Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 10A BlOck 5 Walter Pipple Subdivision Affadavit Attached: ([) Letter A%tached: ( ) D~sapproved: Date: Department Worksheet: MUNICIPALITY OF ANCHORAGE DEPT. O,: l',:' U;I & DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [}~x!VJS©b!h~ENF,\i- HF>F:{',TION 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 [~.i~¥ ~ 'i![/~ REQUEST FOR APPROVAL OF ,ND,V,DUAL SEW.R a.d WATER AC,L,T,ES 1. Type of Inspection: VA FHA CONV. ~ 2. Property Owner:_ David & Betty Raulerson Mailing Address: Day Phone: 694-9185 3. Name of Buyer: Carl H. & LaRue E. Faust Mailing Address:--P.O, Box 1001 Eagle River, Ak. 99577 Name of Lending Institution:_ ALASKA NATIONA~ BAt~ Mailing Address: Pouch 7-010 Anchorage, Ak. 99510 Name of Realtor or Agent: Day Phone:. 694.2631 Phone: 278-4581 Nell Gibbs - Chugiak-Ea~le River Realty Mailing Address: Box E Bowley lane Phone: 688-9111 chugiak, Alaska 99567 Legal Description: Lot iOA Block 5 Walter Pipper Subdivision Location: 104 Easy Street Eagle River, Alaska 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Single-Family Dwelling No. Bdrms. 3 Public Utility. Individual. XX If Individual, number of dwellings presently served One If Individual, depth of well 96' Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation If you have any questions, please call me. Claudia - Alaska National Bank 278-4581 72-003(3/70) P'-'ARTMENT OF. HEALTH AND WEt ' \RE k~ DIVISION OF PUBLIC HEALTH ~-~' BACTERIOLOGICAL 'WATER ANALYSIS Lab. No. OFFICt I: Records in lhis office indicate thls WATER SUPPL"/ to be of: [] SafisJaclor¥ [] Questionable [] Unsalisfaclor¥ Sanifary Status. CITY [] Yes (~ No When? J Diameter of Well_ Depth ~:eel We I Casing Analysis shows this Waler SAMPLE Io be: .V/.~ [] Satisfactory [] Questionable ~] Unsatlsfaclor¥. Jf an "Unsatisfactory" or "Queslionable-.slatus is indlcaled above you ShoUld take immedlate action as recommended below. ']. 1 NotiJy consumers water is polluted. Boil or chemicaliy Ireat this water os oullined in lhe enclosed leaflet "Drink It Pure." 2. Increase chlorinallon sufficienfiy lo meel recommended residual sfandards. Determine source of contamination and faJ~e achon necessary to mainlail~ a sale water supply al a limes. 6. Improve your [] spnng ] aug well [] driven well [] dHl[edwell [] cistern. SANITARIAN'S REMARKS READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE BAC(ERIOLOGICAL WATER ANALYSIS RECORD t am OateRecei~ed .~-~ trl- '2-7 tlme Received L/ .pr~?L~b.No ,~45~ Lactose Broth ~ 't I 0cc 10cc I 0cc 10cc I 0cc I 0cc 0.1 cc 24 hours 24 hours 48 hours