The URL can be used to link to this page

Home My WebLink AboutWENTWORTH BLK 1 LT 4, 5 GAAB-HD- I GRI~ATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCATION ADDRESS LEGAL DESCRIPTION /-.O~- ~' t~/. PHONE SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY / ~.j/~? NUMBER OF MATERIAL COMPARTMENTS. GALLONS. INSIDE LENGTH '~ INSIDE WIDTH ~/ / LIQUID DEPTH SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL_ NEAREST LOT LINE SEEPAGE PIT: / OUTSIDE DIAMETER OR WIDTH DISTANCE FROM WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) · BUiLDiNG FOUNDATION FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE FOUNDATION DISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACH LINE , NEAREST LOT LINE TRENC, H WIDTH_ DEPTH OF FILTER MATER AL BENEATH TILE TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WELL: TYPE ~;"'""~'~"¢/ ,DEPTH jO / NEAREST SEPTIC LOT LINE , SEWER LINE _, TANK DISTANCE FROM WATER , BUILDING FOUNDATIOI~ ~ j SAMPLE , NEAREST ~jJ SEEPAGE '~ OTHER ,SYSTEM ]0 ,CESSPOOL ,SOURCES DISTANCES: DIAGRAM OF SYSTEM DATE APPROVED I ' q HEALTH AUTHORITY GREATE ANCHORAGE AREA ,'OROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 Case No. SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT'"~ RESIDENCE ADDRESS '~)-~ LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK. . MAILING ADDRESS .~ '~" r"~, PHONE NO LOCATION OF INSTALLATION ~'~ ~ V"~, SEEPAGE PIT C~ , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY ~-~ ,~~'''4~ ~"~¢'~""~' '~ F iNAN CEO TH R 0 UGH ~.j?,.~ TO BE INSTALLED BY '~,~ PERCOLATION TEST RESULTS ~/~ ANTICIPATED DATE OF COMPLETION ~ ~;~ BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ~ '~ ~ ' ~ ,.AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED · SEPTIC TANK SIZE DISTANCES: ~ tO -- TYPE ('~.~'/t~A,~ SEEPAGE AREA ,:~~2~2-'~/TYPE '%/ ~.~.~_~,- DIAGRAM OE SYSTEM Health Authority 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. ~anuary 24. bit. Lawrence Curtsy 3250 E. 40th Avenue Anchorage. Alaska 99504 Deal' Mr ,~ Currey: It has been brought to our attention that public sewer is available to Lot 5, Block 1. l!/entworth Subdivision locsted at 3250 1':, 40th Avenue. According to Greater Anchorage Are~ Borough Ordinate, Chapter 16, A~tiele I6.45, Section 16.45.050: "Septic t~nk-~eepsge system 8ewag~ disposal faeiliti~s shall not beinshdled or used on any premises where s~nita~ sewers are ~v~lable within seventy (70) feet of the nearest lot Hne of said premises , ,." The Greater Anchorage Area Borough Public Works Department has' checked their records and conducted a dye test which indicates that you~ structure(s) is not connected to the sanitary sewer. Would you pleas~ check your re~rds to verify that the st~cture(s) is or ig not connected ~d n~lfy uo immediately if you~' records indie~e that a connection ha8 been m~de. If we do not hoar from you within seven (?) days, we will ossume that our records are correct. Vie, therefore, request you connect any and all st~cture~ located on the subject property to public sewe~ by June 15, 1975, You must apply for a connection permit from the permit officer for the Greater Anchorage Area Borough, 3500 l~ast Tudor Road. If you have any questions regarding the above, please do not hesitate to contest the p~rmit officer at 279-8696, extension 259, o~ the Department of Environmzntal Qu~lRy at 2~4-4561, extension 141. Sincerely Les Buchholz ,. R.S, Sanitarian LB/Iw GREATER ANCHORAGE 4 REA BOROUGtI D YE , 'ES T Tax ~de.. I Dat~.. MaWing Address; User / Tenant: Property Address.. SubdN/sion, ~lock II ot DYE TEST: [] Neg~t/ve ADDITIONAL INFORMATION: Offi¢~: Administered By: PW-062(7 74) ANCHOI~GE ArEA BOROUO[t ~.~ !~ALTI-i DF. PART~MNT EAGLE STREET ~uNCHORAGE, ALASKA 99501 279-2511 INDIVIDUAL SEWAGE AND WATER FACILITIES FOR 1. Approval Requested By ~/ f /~ 2. Property O~ner ~ Phone 4. T~e of ~acilit¥ ~o be Inspectea~ ~T~ET: ,~ Nu~r o~ ~oo~, ~ / f ~ S. Well Data: A. Type B. Depth C. Size D. Construction Sewage Disposal System: Septic Tank (If homemade, show diagram on back) 3. Manufacturer 4. Installer Approval Request for Se~ ? ~ Water Facilities Page T~o ~-~ Seepage Pit 2. Lining ~ C...Disposal Field 1. Number of Lines 2. Total Length Required t4easurements A. C. D. E. F. G. H. Well to Septic Tank Well to Seepage Pit Well to Sewer Line Well to Property Line Well to Other Possible Contamination Foundation to Septic Tank ~,~ z Foundation to Seepage Pit Seepage Pit to Property Line~ / 8. CO~/ENTS: DISAPPROVED: DATE: APPROVAL VALID FOR ONE YEAR FRO~I DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT EDll70 b, Detergent .... , ~,h ~ t ~ , ,~ f' "--- 6. We]_l data: aa Type_~~ c. Casing Size ~ // d, Distance from well to closest existing or proposed: 1, $*wer llne Septic tank Cesspool~,, 5. Property Line /~, ,. 6. Other sources of possible contamination, i.e~'~creeks, lakes, houses, barn~ drainage ditch, etc. ~.~ - S ewR~e disposai system.~ a. Age of system~_~ b. Septic tank capacity in gallons~~ c. Name of septic tank manufac~u~e~ 1. If "home made" show diaFPam on reverse side of this form. Disposal~field or seepage pit size and 1. Dis~ce to p~pe~.li~e ~ to house fo~datio~ ~' f. Pemcolation Test performed by . J ~ . - --' ~Use the r~verse .side of this form to show dlaEPam. Diagram should include ..~.~he foilowlng informlation: ~opemty llnes;.w~ll location, house location, ~%~Np~ic tank locatlon~ disposa~ auea location, l.~catlon o~? percolation test, a~ dtreotion of ground slope. 9. The ~for~ation on this form is true and correct to the b~st of my knowledge. Signature of Applzcant D~te Signed TO BE FILLED OUT BY HEA~LTH DEPART!.?,~NT PEgSO!{~iEI he above desc.ribed panttary facllities are hereby approved, s}~bjecr to the .......... '~l%owin~ o,on4¢~ions: ~ Conditions: The above described sanitary facilities are disspproved for the following reasons~ "' -. Date ?' ].,'.{, :'~.D. ~ Ap~val is valid fo~ one year following the date of approval. -.~ CPJ: cw 4. Numbex of bedrooms in house 5. ~;aTe~ Analysis: a. Bactaz. ia],,, b. Detergent .... "' Well data: b. Depth_ c. CasinE Size Distance from well to closest existing, or proposed: 1, Sewer llne Septic? i 3, Seepage Ar, aa /fz~ Sewage disposal system. /'~ b. Septic tank capacity in galiorm c. Name of septic tank manufactu~9? Cesspool'__ Property Line. ./~ ! . Other sources of possible contamination, i.e.~ creeks~ lakes~ d ' houses~ barn~ teenage ditch, e~c.,. , 1. If "home made" show diagram on reverse ~ide of this form. Disposal field or seepaae pit size and type //~-. 7 ' 1, Distance to properc~y 3~ne to house ~otmdation~____ e. Perco.katio~ Test '~esu_Yts f. Percolation Test pe~fopmed by ""AL. Use the reverse .side of this fomm to show diafPam. Diagram should include ~x%he foilowing information: p~opePty tines;.well location, house location, wapt£¢ tank location, disposal area location, location of percolation test, a~ dlreetion of ground slope. 9. The infox~tion pn this form is true and correct to the best of my knowledge. 'S'ig ' ' ' ~a'ture of Applicant '' ' D~te Signed \, TO B~E_FILLED OUT BY HEALTH DEPART~-~ENT PERSONNEL ......... }6'llowin g cond~'~ons Conditions 1__ The above described sanitary facilities are disspproved for the following Approval is valid for one year following the date of approval. CPJ: cw