HomeMy WebLinkAboutKLUANE TERRACE TRAILER EST #1 LT 9LOT
~REATER ANGiORgGE AREA BOROUGH'
'."!EAL~I DF. PAR%ENT
$27 EAGLE STPd2ET
ANCHORAGE, ALASKA 99501
27§-2511
DATE PECEIVED .~2, ~FU,~¢. g
INSPECT: ... ~Zd7cz
REQUEST FOR APPROVAL OF
INDIVIDUAl, SEWAGE PallID WATER FACILITIES
FOR
Approval Requested By
Address
Phone
Property Owner
Legal Description
Type of Facility to be Inspected
Number of Bedrooms
Well Data:
A. Type
B. Depth
C. Size
D. Construction
E. Bacterial Analysis
6. Sewage Disposal System:
~. Septic Tank (~ homemade, show diagrams, o~ b~.e~!~X~ '
S. Nanufacturer ~~~- ~~l ~
,A~proval Request for Se~ ; ~ Water Facilities
Page Two
B, Seepage Pit
1. Size
2. Lining
C. ,Disposal Field
1. Number of Lines
2. Total Length
Required Measurements
A. Well to Septic Tank
B..Well to Seepage Pit
D.
E.
F.
G.
H.
8.
Well to Sewer Line
Well to Property Line
Well to Other Possible Contamination
Foundation to Septic Tank
Foundation to Seepage Pit
Seepage Pit to Property Line
CO~NTS:
./
APPROVAL VALID FOR ONE YEAR FROH DATE SIGNED.
DISAPPROVED:
GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT
EDll70
'~'~' REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES
(Fill out in Triplicate) , . ~.~ ~.
person requesting approval.~~~~~
Watem~..Analy~is:
b. Detergent '
d. DiStance fmom well to c osest existi ~se
1. Sewer line
2. Septic tank
3. Seepage Area
4. Cesspool'
houses, barn, drainage ditch, etc.
Sewage disposal system.
Property Line
Other sources of possible contamination, i.e., creeks, iake~,
a. Age of system
~'" '~ b. Septic tank capacity in gallons. ~r//~/~z~z~,-~
c. Name of septic tank manufactu~ ~'
1. If "home ma~e" show diagram on reverse side of this form.
d.' Disposal field or seepage pit size and type
1. Distanoe to property, llne to house foundation
· e. Percolatio~ Test.'~e suftts
f. Percolation Test performed by
Use the reverse.side of this form to show diagram. Diagra~ should include
~-%he foJ].owlng information: property lines~.well location, house location,
r~l~t~c tank location, disposal area location, location of percolation test~
an~ direction of ground slope.
The ~nf~,~n~on .on this form is true and correct to the best of my knowledge.
Signature 'of Applicant
Date Signed
TO BE FILLED OUT BY HEALTH DEPART!:~ENT PERSONNEL
above described sanitary facilities are hereby approved, ~ubject to the
~61!owing condil~ons:
Conditions:
The above described sanitary facilities are disapproved ~or the following
reasons: -
'Signature of
Approval is valid for one year following the date of approval.
CPJ: cw
GREATF:R ANCHORAG~ A~A BOROUG?,
$27 E~gle SDeei ANCHORAGE,PHONe 272-6467ALASKA 9950~
June 6~ 1967
~,!rs. Edith Skinner
Alaska Department of
Health & Welfare
527 East Fourth Avenue
Anchorage~ Alaska
Dear Mrs. Skinner:
An inspection was made by this Department of the
Nashua t~ailer on the property of Alma and Dorothy
Thayne as per your request on June 6~ i967,
The water supply and sewage disposal system passes
our stemdards and although the bedrooms are rather
small to accommodate two girls apiece~ this residence
meets with our approval.
Sincere ly ~
JKL/srr
DAVID Ro L. DUNC~[~ M. D.
Medical Director
~"'/~hn Ro bee, San±tartan
AIR MAIL TO ALASKA IS FASTER
Geographic _ocation
Name of Establishment __ .of estabHshmen-
Mailing Address
A[oska
Sir: An inspection o~ your ,,)renqisos has ,,~]s ~cy bean mane, ~ne you ere notitiad sf me defecls m~rkea screw
wRh c cross (X) in column morkcd wi[h ,r, ~'},c ~c~ecls norea sno~m T.. carte
3 Ventilolion
4. Healing
5. _~gn? ng
Cro,,,ding
7. Layout of Premises
s. Rodent Control
insect Coairol
lO. VVaier Supply
il. Plumbing
]2. Sewage Dispose
]3. Liquid Wastes
]4. Re~use Handling
Toilet Facilities
]6. Han~wesnmg Facilities
t7. Safety Equipment
18. Prectice of So ety I1
'-}9. Radiation Se{e-t,/ ~_
20. Trailer House Spacing
2l. Occupational Health
22. Nuisance, Control
23. Air ?oligl~on"Cbnfrol
24. Noise Conirol
:.Other Inspection Forms Compleled:
7;
,,:.... :-.,
?
RE,'/,ARKS:
__has reviewed this inspection with me.