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HomeMy WebLinkAboutSOUTHWOOD PARK BLK 3 LT 37 GAAB-HD I GP~ATER ANCHORAGE AREA BOROt~H ' HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-251! INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATON ~, f~TZd SEPTIC TANK: D,STANCE FROM WELL (P~/1-~ ~? 0 LIQUID CAPACITY } ~c> GALLONS. MAILING J~/~/~/('~Z"~, ,'~'-/~ PHONE ADDRESS LEGAL DESCRIPTION ~ MATERIAL (3o,~-,,.~q[(ytzo(:~l, COMPARTMEN,S f INSIDE LENGTH INSIDE WIDTH DEPTH_~ SEEPAGE SYSTEM: SEEPAGE PiT: NUMBER OF PITS LINING MATERIAl ~J NEAREST LOT LINE ..i t / OUTSIDE DIAMETER '~- OR WIDTH'" '~' [ 'r~ , LENGTH / '"~' DERTH ~'~ . [~_llt'(~,~ DISTANCE FROM WELl (~1~2 /~B-P , BUILDING FOUNDATION 1.~ Z ':~'7 2- TOTALEFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE F~ROM WELL ~.~F~OUNDATION ~/_,-i~RES~T LINE ~ LINES , ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE LJ/G//~ - DISTANCE FROM WELL: TYPF(. '~' DEPTH--r ' BUILDING FOUNDATION. NEAREST SEPTIC SEEPAGE WATER SAMPLE= /]./~' ., NEAREST OTHER CESSPOOL 6, - , SOURCES__ DISTANCES: :'lc, :; DIAGRAM OF SYSTEM DATE APPROVED GREATEI kNCHORAGE AREA -gROUGH " c.~/-HEALTH DEP. AR-TMENT r 327 Eagle St.~ ~\~t~ ~anch°rage' A~;ka' x~ ~i -} 99501 q)-/Y~ 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT P 5A _CEO THBOUGH ,,P~R~OLA-T-~N TEST RESULTS APPLICATION TO INSTALL: SEPTIC TANK V/ , SEEPAGE PIT / ,DRAIN FIELD ,OTHER TO SERVE THE FOLLOWING FACILITY ~ ,~;~:~. ,/~ Z/[~'.~" BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THmS ms TO SERVE AS . ~' , PERMmT TO mNSTAkk A ~ ~/~¢ AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED OISTA~CES: TYPEL'~-O/C/C~'~EEPAGE AREA TYPE L'~/'~'¢~- -- DIAGRAM OF SYSTEM '~7//b~"~~'' HEALTH HORITY OR LICENSED DESIGNER I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the ab°ye describe;ye7 in acc°rdance with said c°de' ~7n~/2_ t~ ( tREATER ANCNORAGE AREA BOROU~H;~ HEALTH DEPARTMENT 327 E^GLE STREET ANCHORAGE, ALASKA 99§01 CASE # r~al Descrio~ion: Lot 77 Block ~ Subdivision c~/./A..,~ ~3.,~ J This Form Repo~ts al Soils Log. t~, ,-- · .Percolation Test ........ ~ ...... Depth Feet Soil Characteristics Location Sketch Was Ground Water Encountered?_~.~ if Yes, At What Depth Reading Date Gross Time Net Time Depth To H20 Net Drop Test Performed Data Certified By:~~_~Z~ Dat~)/~ Proposed Instal~Seepage Pit ~ Drain Field Call 279-9591-D2m ,amic Rea] ~ HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL ,SYSTEM '] Vetera~as Administration PART I.--TO ~E COMPLETED BY FHA ~_MAI~ M~l~ju~ D. & Bernice E. SUBDIVJ$iON NAME aoast ~o~l;~.D~ 0o~p~w4r27h-36~ .... Po 0~-3~ ~g~-Age'~ ~.- ~.~99 366 ~ 2607 W. 67th Avenu% ~o~age~ ~aska jLP! 37, ~lock 3, Southwooa P~,rk S/D. ~ BLOCK NO ; LOT NO. [] IXablic system [~ Community system '--]Community system ' 3 ~ 37 PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT / I 'Il [I ; ] : , ~lh ,,,~l,,,,, ,~,,,, ~,, ,,,L~,,.I,~ ,, : Ii '~ Il ' , i ] ~ , I : ~: , I~ . : I Ill I I ] i II ill~ iii J i lll[l ~ J J J J JJ I 'l Ill; liil i ' ; ifil ll;i filliP- i~' J I J J ~ J J I J J J !ill I :l:l~ , Il! I l::[llllll ;ill  ~ , Il J J I l; ] !~ i : I i J J F I l J I i J I ~ J ii t1[il I, I /Ill lllZ I ~ lit I ~-: tl : LI I~L Ii~ L~ I~I i~'-]ll!: ' , ~' '~ , r: :. ,~' ~:' ' '[I, :!1 ':~ , ~ ~i[!!:i! ,, ==.~L : T ~' ,. ~,t1~ ', ' .... ~" ' J [] Can be expected to function satisfactorily, and is not hke]) to ~reate an insamtan' condition It is the opinion of the [] State [] Counw [] Local Department of Health that mis individual water.supply system [~(is [] ts not s,~nsfactory as a domesnt water supph' for the sublect propert-,'. It is the opinion of the [] State [] County [] Local Department of Health tha, Iht, ml~vldual sewage-disposal ~,ys- De expected to function satisfactorily Environmental Control OfficerJ · J~'3500 BATER ANCHO~AGB AREA BOROUGH Department of Environmental Quality Tudor Read, Anchorage, Alaska 99507 279-8686 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATH. R FACILITIES FOR Address 2. Prooerty O~ner: 3. Legal Description: 4. Location: 2~ 5. Septic Tank: 1. Seepage Pit: t. E. Disposal Field: Distances: A. Phone: Phone: Type of Facility to be Inspected: Number of'Bedrooms: A. Type B. Depth C. Construction. D. Bacterial Analysis' Sewage Disoosal System: 0-~ --/~-~' ~ 197° C. Size~'~ 2. Manufacturer Total Well To: Septic Tank , Nearest Lot Line Foundation to Septic Tank__ , Absorption Area , Sewer Lines , Other Contamination ~ Ab§o~ption Area '- C. Absorption Area to Nearest Lot Line Re~u¢,st~for Approval of A,,,,ividua] Page Two Comments: Sewer & ~Nater Facflitie~ ~ Aporov ' pproved Date Ap,~ro'¢a]/1~31id for One Year Fro,~, Date SlQned Greater Ancho~g?~ea Borough~ Decartment of ~-nv!ronmenta] Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities located at: Signed Date FHA Form 2573 U. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL HOUSING ADMINISTRATION HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.~TO BE COMPLETED BY FHA iNSURiNG OFFICE MORTGAGEE SERIAL NO. JPROPER~ ADDRESS 26~ ~4est 6~th, Anoho~'a~es Alaska ~Loc~ NO. LOt NO. MORTOAGOR OR SPONSOR SUBDIVISION NAME TOTAL NUMBER: WATER SUPPLY BY: [] Public system BASEMENT [~Yes [] No [] New installation [] Community system Can attic or other area be made Into additional bedrooms? (If Yes, how many~) SYSTBM DESIGHED FOR [] Individual NO.~F BDRM$. GARBAGE'DISPOSAL [] Individual [] Yes [] No SBWAGE DISPOSAL [] Public system ]Community system PART II.inTO 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 [] is not satisfactory as a domestic water supply for the subject property. (//Z?/z.'j/. a It is the opinion of the [] State [] County [~Loc~l Department of Health that this individual sewage-disposal sys- tem with proper maintenance: [~]~Can be expected to function satisfactorily, and [] Cannot be expected to function satisfactorily is not likely to create an insanitary condition PART Ill.--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. DATE SIGNATURE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM DEPU1T FOR CHIEF ARCHffECT FHA Form 25~e Rev. July 1958 October ]9, 1973 Mr. Mel Metr 6702 N. 67th Avenue Anchorages Alaska 99502 Re: Public Sewer Available to Block 3, Lot 37, Southwood Park Subdivision Dear Mr. Melt: Borough sewer is now available to you. Your present sewer system, is located too close to the community well which serves you. Due to the location of your sewer system, you will need to connect to borough Sewer by Nay l, 1974. You will need to obtain a sewer connect permit from sewer maintenance at 3500 Tudor Road. before the connection is made~ If you have any questions concerning this matter, please contact me at 274-4561, extension 137. Sincerely, Robert C. P~att, Environmental Control Officer III ReP/ko Certified #740192 RECEIPT FOR CERTIFIED MAIL--30c (plus postage! POSTMARK SEN¥ TO OR DATE ~ws to who~t~ivered 15~ ~VER TO A~ ONLY ................ .:~ .,.. 506 PS Form 3800 NO INSURANCE COVERAGE PROVIDED-- .:-~u)y,12. 1973 ~! ~:--;.' ' '. . 6702-'::N. enue :~ -. Anchorage, "Alaska CC · ~_Publi¢ Se : 'AVail ble BlOCk :- .... SUBJ .T, :-' ,$Ou'thwood Par'k:Subd4Y:t:siOn '~-,'~_ ~;~'~ :.-":; ;', Dear M~ -:A'dams: ' "- Bor~u~h;:S~er t _ sys.=.e~ is-- l:oca.~'ed:to C'l'ose to the community we'll~-:j, whi~h serves ~ou; +'OU'e: tO~'~h'e locate'on 0f y6~; sewe.r-system', 'will need t0:,:'conn;e~t :.~0;borough:'~ewer~--by _0'c~O~er~. 31 ;~ ~:FYo?. will ne-&'d, to/,q~.:ain a~se.er*:conneb~- Pe'rm:tt .fro~-s~b'~ ~ -malntehance a~t:3500.Tu'~:R0ad bef0re;the-cOnnec.~:on ~s made. .'..i.f you, have-an~.que~tions~conc~rnin.g ~hts- ~-'.contact me,a~;~'~2-7.4~4~61-; e.x'te'ns~on lJ7.' Rob'e~t C.' - -:..,;_ :..., . Environmental :Control '.:O~ftcer -I:H ' ?'` ' - RECEIPT FOR CERTIFIED ~AIL--30c (plus postage) RETURN ~ 1. SERVICES 2, Shows POSTMARK OR DATE PS Form Apr. 197 3800 NO INSURANCE PROVIDED~ (See, ..~FOR INTERNATIONAL MAIL