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Home My WebLink AboutWILDWOOD BLK 1 LT 4ALoT 151oc, GAAB-HD J GRI:4TER ANCHORAGE AREA BOROUGH ~r ~ ~/ HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION MAILING - ~ ,/~ .~ ADDRESS ~),,~/~ i1~;¢'/.?j'7 /_.~ PHONE LEGAL DESCRIPTION ~ ~ ~{~ { ~*~t~ ~'~S& SEPTIC TANK: DISTANCE FROM WELl LIQUID CAPACITY MATERIAL ~.~6-'r~ 9'~_~... COMPARTMENTsNUMBER OF t ~ ~'~ ~O~j~ ~C'~ LIQUID GALLONS. INSIDE /ENGIH INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS i OUTSIDE DIAMETER LINING MATERIAl ~,~J NEAREST LOT LINE OR WIDTH ~ ~' · DISTANCE FROM WELl ~'~'J~ ~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ,LENGTH f~/ ,DEPTH , BUILDING FOUNDATION ."~'"~¢"~ ~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA SQ. FT LENGTH OF DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: LOT LINE TYPE DEPTH NEAREST · SEWER LINE DISTANCE FROM IC~' BUIL~ FOUND '10 ' .~ SE lC SEE · TA . BYS WATER SAMPLE CESSPOOl NEAREST OTHER SOURCES DISTANCES: DIAGRAM OF SYSTEM DATE APPROVED GAAB-HD-2 GREATEk ANCHORAGE AREA, ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511' · , Case No. SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT RESIDENCE ADDRESS ,.~,'~,' ~s .,.,,~,',//--,~. ! LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK V/' TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH F H ~ ANTICIPATED DATE OF COMPLETION LOCATION OF INSTALLATION .~/~/'~,~/ ,SEEPAGE PiT. ~ , DRAIN FIELD , OTHER TO BE INSTALLED BY ~-, A, 5 ~T EST, R ESU LTS '~'{~ ~-_~¢ BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS ~"~'~ ~TO~O~ , PERMIT TO INSTALL A S~,~~ ~G)~,~ _~,Z,,/.~.~ AS DESCRIBED BEk0W. SIZE OF UNIT TO BE SE.VED ~ 4 ~~ . SEPTIC TANK SIZE lZ~ TYP~~SEEPAGEAREA .~/2/7/ TYPE DIAGRAM OF SYSTEM DISTANCES: :ertify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the bore described system is in accordance with said code. 0ATE /~"~/~/~.Y APPLICANTS SIGNATU RE ~'"'/~'~'J// A~CH.)Ra ..... ALE.. BEA~Th u~l nr,~ .EJT 327 EAGLE STREET AI.ICHORAGE~ ALASKA 99501 Depth , . Feet Soil ch~ ..... ~e~otxc Location Sketch /~.<_/ x/~/ ~.~-/ ,~./? }tas G~ound t:ate~- ~ncountered?_~/__~_~ If Yes, At What Depth .......... Reading Date P~oposed Installa~ Net Time Depth To H20 on: Seepage Pit' / · _~ _ ~D~a~n Field · Depth'O( Inlat ~.~/~ Depth To Bottom Of Pit O~ T~nc.'~-"7~ Data Certzfled By:~v~/f...me~'i~ Date.' · ~-'- _~~z..~y' ~ ~ .,- ~.~ GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Insoectio~ Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR L Approval Requested By: Address, ~'~ 7~ 2. Prooerty ~ner: Number of Bedrooms~ 6. Well Data: C. Construction Sewage Disgosal System: A. I ataned//-- B. C. Septic Tank: 1. Size/-~'~ 2. D. Seepage Pit: 1. Size 2. B. Depth D. Bacterial Analysis Installer Manufacturer Disposal Field: Total Length of Linee Distances: A, ~elk To: Septic Tank Nearest Lot Line Poundatlon to Septic Tank '//'__ Absorption Area to Nearest Lot Line Phone: 3 ~"~,~ -~--~ Phone, Absorption Area , Sewer Lines · Other Contamination "~. Absorption Area ~=~/ / Requast for Appgoval o£-~'rfidivi~ua] Page Two 9. Comments: Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Envtronmenta! Quality DIAGRgM OF SYSTE~.. I certify that the information contained in this request for appreval to be a t~ue and accurate representation of the ~ubiect ~ewer and water facilities located at.' Signed Date ~..~ATER ANCHORAGE AREA BOROU~,_2'' APPROVAL ADDRESS: PHONE: PROPERTY DEPARTMENT OF ENVIRONMENTAL 3500 TUDOR ROAD ANCHORAGE, ALASKA 279-8686 QUALITY 99507 DATE RECEIVED: INSPECT: /~ ~0 TIME: ~~-~ REQ~ESI FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR O~NER: ~~ PHORE: TYPE NUMBER OF BEDROOMS: WELL DATA: B. DEPTH C. SIZE D. CONSTRUCTION E. BACTERIAL ANALYSIS 6. SEWAGE DISPOSAL SYSTEM: A. SEPTIC TANK ~ ' S I Z EI 2. 3. 4. MANUFACTURER INSTALLER (IF HOMEMADE, SHOW DIAGRAM ON BACK) APPROVAL REQUI~" FOR SEWER PAGE TWO & WATER FACIL~'~-~S B, SEEPAGE PIT C. DISPXO~L FIELD 1. NUM~OF LINES· 2. TOTAL LENGTH B. WELL TO SEEP~x~T. C. · WELL TO SEWER LINE~ PROPERTY D. WELL TO LINE ~'~ · ~NA E. WELL TO OTHER POSSIBLE C TION F. FOUNDATION TO SEPTIC TANK '"~/~ ~' G. FOUNDATION TO SEEPAGE PIT ~7z~ / H. SEEPAGE PIT TO PROP. ERTY LINE ~ 8. COMMENTS: APPROVED~"~-~'~~PPROVED: DATE: DATE: APPROVAL VALID FQR ONE YEAR FROM DATE ~SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITI ~:HA Form 2573.'~ Rev. July 1958 L~' i,~ U.S, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT ')~ FEDERAL HOUSING ADMINISTRATION HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART L--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAl. NO. MORTGAGOR OR SPONSOR PROPERTY ADDRESS SUBDIVISION NAME BLOCK?. LIVING UNITS B~DROOM$ BAIH$ BASEMENT ¥es [] New installation Can attic or other area be mode Into additional bedrooms? (If Yes, how manyF) SYSTEM DESIGNED FOR WATER SUPPLY BY: ]~1 Public system [] Community system [] lndividnal .o. o, ,.,Ms. .^.^G,B,s,os^t [] Public system [] Community system [] Individual /~ [] Yes o 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 []isnot satisfactory as a domestic water supply for the subject property. (t~71~£ S~ ~ l ~- g~.,~['~]~)C~r/) It is the opinion of the [] State [] County [] Local Department of Health that this individual sewage-disposal sys- tern with proper maintenance: ["~ Can be expected to function satisfactorily, and is not likely to create an insanitary condition ]Cannot be expected to function satisfactorily NOTE: The health authority should, complete the appropriate opinion statement above and affix date, signature and title in the spoce~ provided. Use of the above grid 'for Health Department nspector's sketch as well as use of the back of this form Ss at the option of the health authority. 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 __i CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT DATE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July 1958 REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY TREATMENT consists of [] Septic tank. [] Cesspool. ___.feet. Material fret. Inside width, gallons. Capacity inlet compartment, feet. Liqukl depth, .feet. Sept!c Tank: Distance from well. Total liquid capacity, __ Inside length, Dishance from: Well. feet; foundation, lnskfe diameter, feet. Depth, $lCONDARY TREATMENT consists of [] Tile disposal field. Distance from: Well, Total length of tile lines. Trench width, Length (if each line, Type of filter material: [] Gravel. Number of compartments . gallons. feet; nearest lot line at [] front, [] side, [] rear, .feet. Liquid capacity. .gallons. Lining material [] Seepage pits. Other feet; foundation, feet; nearest lot line at [] front, [] side, [] rear,__ feet. Number of lines, Distance between lines, inches. Total effective absorption area in bottoln of trenches, feet. Depth1 top of tile to finish grade, [] Broken stone. Other feet. square feet. inches. Depth of filter material over tile, feet. Lining material __feet; nearest lot line at [] front, [] side, [] rear~ inches. Depth of filter material beneath tile,~ inches. Seepage Pits: Number of pits .... Outside diameter, feet. Depth,. Distance from: Well, feet; building foundation, In$~len made by: [] 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. Indivkiual wells [] are [] are not customaty in neighborhood. Give most recent rccord of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborh~×~d [] are [] are not being developed with both individual water-supply and sewage-disposal systems. Lot size: feet wide, feet deep. Dwelling set hack from front property line,~ feet. Individual water supply I¥om: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. Distance of well fram: Building foundation 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, ~'eet. 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. Pump: [] Shallow well. [] Deep well. Length of drop pipe, __ feet. Pump capacity, l~}cated in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] lhamp 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, FHA Form 2575 Form Approved HEAL?H AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM Anchorage First Federal Bank 11t:0~363-263 MORTGAGOR OR SPONSOR Kenneth J. Jackson ~O~K ¥. LOT .~. WATER SUPPLY IT: ~1 Public system ~'~W~, DISPOSAL mY, l~l~ew installation r-{ Community system n-] Public system [~] Community system [] Individual Individual . 4 []Yes.No PART II.--TO B~ COMPLETED GY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the 1~] State [] County [] Local Department of Health that this individual water-supply system [] is [] is not ~tisfactory as a domestic water supply for the subject property. C.A.U. It is the opinion of the [] State [] County [] Local Department of Health that this individm/l sewage-disposal sys- tem with proper maintenance: [] Can be expected to function satisfactorily, and [] Cannot be expected to function satisfactorily is not tik~y to create an insanitary condition. SIGN~ATUaE //7,,/,' f~ ~'-/Y ]TITLE Do~. 20, ~7:L/- ~.~ ~.,-, r,-/; ,.~-:;'> '~:/-'" ~ a,~i~o.~.t~ PART III.~FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITEI~: I have reviewed the foregoing and the pertinent FHA Compliance Inspemon Report. and recommend that the Individual writer-supply system be considered [] Acceptable [] Not Acceptable Sewage dispOsal be considered [] Acceptable [] Not Acceptable. DATE SIGNATURE 141ALTfl AUTHOliI?~' &PPKOV&L INDIVIDUAL WATIE! SUPPLY AND SEV/AGE DISPOSAL SYST~I~ ] CHIEF AItCHITECT ] DEPUTY FO~ CHIEF ARCHITECT REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM Length of each line, __ feet. Deplh, top of Iile co finish grade, inches. Inspected by. teec Liquid depth .... feet. RI!PORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM Properties in neighborho(~d [] are [] are not being developed with both individual water-supply and sewage.disposal systems. Lot s~ze: feet wide, .feel deep. Dwelling scl back from front property line, ~feet. Individual water supply from: [] Drilled well. [] Driven well. [] Dug well [] Bored well. feet; nearest lot line at [] front, [] side, [] rear, __feet; ~ile sewer.__ f~et; ~eptic tank, feet; disposal field, -feet; cesspool, feet; other sources of possible pollution, ~Ceet. Diameter, _inches. Total deplh, feel Type of casing.. Approximale depth to pumping level of water in well,, feet. Approximale yield, Sealed watertight to deplh of feet. Exterior space around casing scaled with: [] Cement grout. [] Puddled clay. [] Ordinary backfill. Well cover: [] Concrete. 1'3 Wood. [] Metal. Openings in well cover wate.ight: [] Yes. [] No. Pumpl [] Shallow well. [] Deep well. Length of drop pipe, feet. th.m~p capacity. Located in: [] Basement. [] Pumproom off basement. [] Pumphouse ab.ye ground. [] Pump pit. Pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No. 'I'ylx. of storage: [] Pressure.. [] Gravity. Capacity. gallons. Has bacteriological examinalion of water been made? [] Yes. [] No. If answer is "yes." giye 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. [] Lo~al Health Authority. Inspected by Date of inspection 19 Depth of casing .gallons per minute. .gallons per minute. feet;