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Home My WebLink AboutWENTWORTH BLK 1 LT 6 ~%'~EATER AN~,HO~Aj~ AREA ~OROUGH Department ef ~nv~ronmen~l 3500 Tudor Road. Anchorage, Alaska 99507 279-8686 Date Received Time of Inspectlon__~L~._~_~- F/3/2)'7_ Date of Insoectlon ...~ REQUEST FOR APPROVAL OF INDIVIDUAL SEi¢/ER & WATER FACILITIES FOR 1. Approval Requested By: Address:~? Phone: 2. Property Owner: ~~ ~:, _ 3. Legal Description:~___~_~_ ¢~/ d~ 5. Type of Facility to be Insoected:___~_ _~_ Sewage Disposal Svstem:p~ // (~ A. Installed / Bacteria] Analysis Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Size 2. Material Disposal Field: Total Length of Lines 8. Distances: Well .~a , Sewer Lines · Foundation to Seot~c Tank "~ Ab'~orotton Area . Absorotion Area to 51earest Lot Line Request for Approval of Ir~ividua] Sewer & Water Factlit~e~ 9. ~Comments: ~, ..... ,%p.~o~a~ ,a,xd ~or 3ne Year 'F}tor~ Date Si,_~ned Greater Anchorage Area BorouQh, Department of EnvY:tangental Quality DIAG. i~AM OF SYSTE~;'. I certify that the information conta~ne, in this request for aporoval to be a true ' ~ bi= and water facf!it.ies located at: and accurate representation of the ,,u,. ~ct sewer Signed Date July 31, 1972 Veteran's Ad{~)inistration 429 D Street Aochorage, Alaska Subject: Mrs. Claypool, 3240 East 40th Ave. NentworCh Subdivision Lot 6, Block 1 Dear Sir: The subject property has a well in a pit which is disapproved. To ~eet requirements the well casing must exte~ld 18~' above §round with a sanitary seal. The pit )~)ust be filled in impervious soil. Sincerely, Les Uuchholz Environmental Control Officer mb ~EATER AMCHORAGE om ~ Department of unvironmental Quality 3500 Tudor ?.oed, Anchorage, Alaska 99507 279-8686 REQUEST FOR APc~!OVAL OF INDIVIDUAL REelER & WATER FACILITIES Approval Reqqested By: __ Address: Phone: 2. Prooertv Owner: ~ Phone: Number of Bedrooms: D. Seepage Pit: 1. E. Disposal Field: Distances: A. Well To: Well Data: _ A. Type [~,,~-~ L.<,'~{( ~ff B. C. Construction ~_~/ D, Sewage Dtsoosal System: A. Installed C. Septic Tank: 1. Sii~ 2. Size ~'x 2. Total. LengtB'~.~ Lines -.% Septic Tank , Nearest Lot Line Bacterial Analysis InstalJer Manufacturer Material , Absorp'tiDn Area , Sewer Lines , Other Contemination B. Foundation to Septic Tank "~, Ab§orption Area C, Absorption Area to Nearest Lot Line Request for Aporoval of T ~ividue] Sewer & Weter Facilit~ 9. ' Comments '. ,, ' ~ ._~_~ Ap~:~reva] Valid for Oral ,Date ~.~p. ed . Greater Anchorage Area BorouQh, ~~nenta] Quality I certify that the information contained in this request for approval to be a true and accurate representation of the suDiect sewer and water faci!it~es located at: Signed Date ~ , REQUEST OR AP R AL 0 ~ / · ' IN~VIDUAL SEWAGE AND WATER FACILITateS i ~f7 t~ame of person requestzng approval 5. Watox~ Analysis: a. Bac tgz, ia 1 b. Detergent_ data: b. Deptt~__ ~ / c. Casing Size d. Distahce from well to closest existing or proposed: 1. Sewer llne .... ~0 2. Septic tank ~' 3. Seepage Ar.aa_ 4. Cesspool~_ 5. PmopeP%y Line 6. Other sources of possible contamlnation~ i.e. houses~ baPn, dPalnage ~di~eh, eYc Sewaga disposal system. c. Name of septic tank manufact~m~r 1. If "home made" show dla~mam on reve~s~ ~de of th%s form. 1. Distance to p~ope~y-.~ne to house fo~dation HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER ,SUPPLY AND SEWAGE DISPOSAL SYSTEM PART L--TO BE COMPLETED BY FHA MORTGAGOR OR SPONSOR P~OPER~ ADDRESS BLOCK NO. LOT NO. UBDIVISION NAME ~ r~t~O~h ~ Yes ~ No , ~ Yes ~ No ~ Public system ~ ~mmuniw system ~ Individual o, ~ ~blic system ~ ~mmunity system ~ Individual ~ ~ Yes ~ No PART II.--lO BI {O~PLIIID BY glatt" DEPARTMENT t is the opinion of ~e ~ State ~ Counw ~ Local Department of Health that this individual water-supply system is ~ is not satisfactory as a domestic water supply for the subject properw. It is the opinion of the ~ State ~ County ;~ Local Department of Health that this individual sewage-disposal sys- ~ Can be expected to function satisfactorily, and ~ ~nnot be exacted to function satisfaeorily is not likely to create an insanit~ condition ri PART III.~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. SIGNATURE rCHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT DATE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form Rev, July 1958 REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM gallons, Capacity inlet compartment, .feet. Liquid depth, Distance from: Well, Total length of tile lines, Trench width Length of each line,_ Type of filter material: [] Gravel. Number of compartments gallons. feet. feet; nearest lot line at [] front, [] side, [] rear, feet. Liquid capacity, gallons. Lining material SECONDARY TREATMENT consisls of [] Tile disposal field. [] Seepage pits. Other Tile Di,posal Field; feet; foundation, feet; nearest lot line at [] front, [] side, [] rear,, fe~. feet. Number of lines, Distance between lines, feet. inches. Total effective absorption area in bottom of trenches, .square feet. feet. Depth, top of tile to finish grade, inches. [] Broken stone. Other Depth of filter material beneath tileq ~inches. Depth of filter material over tile inches. Number of pits .... Outside diameter, feet. Depth, feet. Lining material Distance from: Well, feet; building foundation, feet; nearest lot line at [] front, [] side, [] rear, feet. In~pectlon mud~ b¥~ [] State. [] County. [] Local Health Authority. Inspected by Date of inspection .... 19 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. (Jive 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 frown front property line, feet. Individual water supply I¥om: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. Distance of well from: Building foundation cast iron sewer, feet; tile sewer, seepage pit, feet; cesspool, Well construction: 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. PUmR~ [] 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 an~'. Inspection made by: [] State. [] County. [] Local Health Authority. Inspected by Date of inspection 19 .feet; nearest lot line at [] front, [] side, [] rear, feet; septic tank, feet; disposal field, feet; other sources of possible pollution, .}'eet. Depth of casing, gallons per minute. gallons per minute. feet, feet;