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HomeMy WebLinkAboutSOUTHWOOD PARK Block 4 Lots 19 & 207 OI;Z - 079. GRE' '~.RANCHORAGE AREA BOROUGH ~' HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~ p, ,~. ,~ ~ ,,~ MAILING ADDRESB 8ox LOCATION ~6~O ~¢S'/ ¢ 7 ~ LEGAL DESCRIPTION PHONE .,,¢44,' .,¢ SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY GALLONS. MATERIAL % INSIDE LENGTH. NUMBER OF "~ COMPARTMENTS INSIDE WIDTH ~'--/ DEPTHLIQUID SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: / OUTSIDE DIAMETER /? / OR WIDTH /,,2- DISTANCE FROM WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , LENGTH /,~, , DEPTH BUILDING FOUNDATION 3g'1L SQ. F,. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA FOUNDATION DISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE . NEAREST LOT LINE. TRENCH WIDTH TOTAL LENGTH OF LINES IN, TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE; IN. ABOVE TILE WELL: TYPE L ~ ~L./,.,~_ ~r...?...~ DEPTH NEAREST SEPTIC LOT LINE ., SEWER LINE , TANK. DISTANCE FROM : WATER , BUILDING FOUNDATION.~SAMPLE SEEPAGE , SYSTEM , CESSPOOL , NEAREST OTHER , SOURCES DISTANCES: A->~= ~.9 DATE DIAGRAM OF SYSTEM o 0 0 0 0 ~ - (~), 07~ . _> : · OAAB HD- J, Ge~ATER ANCHORAGE AREA BORO~GH "x~ -~x HEALTH DEPARTMENT .~_,~j, 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /'J FL, ~", -D, ~ L ^ c k,, LOCATION. ~.~.~t01~) 6.L)~,.s-f ~;'7 ADDRESS lbo'¢ '713 /~, PH .LEGAL DESCRIPTION "~7-'/,~'~.,~'0 ,~,¢'.4¢ ~ .~,j'/~ Wood/ /~>1~, SEPTIC TANK: DISTANCE FROM WELl LIQUID CAPACITY /~l~ GALLONS. NUMBER OF ' MATERIAL ~ ~ E t. COMPARTMENTS INSIDE LENGTH ~,// INSIDE WIDTH ~'' DEPTHLIQUID SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH , LENGTH , DEPTH LINING MAIERIAL '; DISTANCE FROM WELL BUILDING FOUNDATION__ NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) TILE DRAIN FIELD: FOUNDATION "'~<~ 'J , NEAREST LOT LINE. DISTANCE FROM WELL SQ. FT. TOTAL LENGTI~ ,. OF LINES NUMBER OE L,NES 7 ABSORPTION AREA DERTH: TOP OF TILE TO FINISH GRADE WELL: T y p E ~--_~ ,0',,.,, (JJ..., DISTANCE BETWEEN LINES .~ TRENCH WIDTH SQ. ET. LENGTH OF EACH LINE · '~-' ~ DEPTH OF FILTER MATERIAL BENEATH TIL~.' DEPTH. IN. TOTAL EFFECTIVE IN. ABOVE TILE DISTANCE FROM WATER ,BUILDING FOUNDATION . SAMPLE. , NEAREST SEPTIC SEEPAGE OTHER , TANK , SYSTEM , CESSPOOL , SOURCES NEAREST LOT LINE ., SEWER LINE DISTANCES: I Loc._~o~j I DIAGRAM OF SYSTEM _-- ~ , 9 DATE APPROVED HEALTH AUTHOR'r1Y ~ GAAB-HD-2 ~ n GREATEk _4NCHORAGE AREA HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 Case No. SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT RESIDENCE ADDRESS LEGAL DESCRIPTION MAILING ADDRESS ~ LOCATION OF INSTALLATION PHONE APPLICATION TO INSTALL: SEPTIC TANK ~,SEEPAGE PIT / , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY ~ Z~e'~/~',,¢-'/' FINANCED THROUGH ~"~./,'~'~ . . TO BE INSTALLED BY ~~ ? PERCOLATION TEST RESULTS ~/"/'"4//~///"'~jANTIClPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS /~¢~' "-~~"~ , PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED · SEPTIC TANK SIZE ;;;',-~"g~ TYPE 5/~-/ SEEPAGE AREA DIAGRAM OF SYSTEM "~"'~/~"'~' · D H";ith Authority I certify that I am familiar with the requkements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. BATE ~,~/~Y APPLICA"TSSIGNATURE / ~-~-~"/~· GREATE i.. ANCHORAGE AREA':. )ROUGH Ca eNo. 1-I EALI*it DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM ° APPLICATION & PERMIT NAMEOF APPLICANT ~", "~), RESIDENCE ADDRESS ~ 5~ ('~ (~ LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH PERCOLATION TEST RESULTS ~ .,SEEPAGE PIT / , DRAIN FIELD TO BE INSTALLED BY ~/~ ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT MAILING ADDRESS ~¢ ~ 7 /5 PHONE NO.~/"~-~.~-~'~ LOCATION OF INSTALLATION c~o~-vV ~(,/. ~ , OTHER THIS IS TO SERVE AS ~' ~'~ ~-- , PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF~UNITTO BE SERVED SIZE ~/0~ TYPE ~'/~ . SEEPAGE AREA ~'~ TYPE~ SEPTIC TANK DIAGRAM OF SYSTEM DISTANCES: 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. BATE ~ APPLICANTS SIGNATURE 4. 5. GREAT~_R ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage~ Alaska 99507 279-8686 D te ReoeiveO Time of Inspection ~.;d JW~ ' REQUEST FOR APPROVAl, OF INDIVIDUAL SEWER & WATER FACILITJES -' ~h-.~ /~c~.X '/~ Approval Requested By: Address: J~ ~ Property Owner: Legal Description: Location: Type of Facility to be Inspected: Number of Bedrooms: ~ Well Data: /~9~ A. Type ~d B. C. Construction . D. Depth Bacterial Analysis Sewage Dfsaosal System: C.~Septic Tank: 1. Size Disposal Field: Installer ~anufacturer Tot. al Length of Lines__ Distances: A. Well To: Septic Tan , Nearest Lot Line "~ Foundation to Seotic Tank /82 · '~ Ab§orption Area ~)/~ Absorption Area to Nearest Lot Line , Absorptidn Area_~/~ , Sewer Lines Request~for Approval of I~<~%.~al Sewer & Water FactlitteL~..'~-~ Page Two 9. Comments, · Ap~r°v~~~/1va DisappToved. Date ~ppro' Valid for O~e Year From Date Siqned Greate~ Anchorage ATea ~orou~h, De~ertme~t of ~mvi~o~men~a~ Q~altt¥ 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 NO. 2573 Rev. 11/71 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 HUD/FHA Form Approved Budget Bureau No. 63-R0296 Insuring Office FHA Case No, Mortgagor or Sponsor: Mortgagee -'Name, Address and Zip Code Peoples' Bank ~ Trust 807 "G" Street / TOTAL NUMBER ] BASEMENT I [] Yes [] No :WATER SUPPLY BY, Public System r',...,,,g. U. [] Community System SEWAGE DISPOSAL BY', [] public System [] Commugity System Prope~y Address: 2500 ~bL~st 6'7th Subdivision: $outhwood Par[: [] New Installation Individual E~ Indiviaual Lot No. Subdivision 19,20 CanAttic or otherAreabe made into additional bedrooms? (If ye~, how many?) [] Yes [] No SYSTEM DESIGNED FOR Garbage Disposal ~ Yes [] No. PART II. HEALTH DEPARTMENT INSPECTOR'S SKETCH TO BE COMPLETED BY HEALTH DEPARTMENT It is the:opinionof the ~ State [] County XLocal Department of Health thatthis individual water-supply system ~A~is ~-~ is not satisfactory as a domestic water supply for the subject property. It is the opinion of thei h proper maintenance: Can be expected to function satisfactorily, and is not likely to create an insanitary condition 5/9/72 SIGNATURE [] State ~ County [] Local Department of Health that this individual sewage-disposal system ~ Cannot be expected to function satisfactorily I TITLE , Sanitarian DATE NOTE: The health authority should complete the appropriate opnion statement above and affix date~ signature and title in the spaces provided, use of the above grid fo~ Health Department Inspector's sketch as well as use of the back of this form is at the opinion of the health authority, · PARTIII.- - FOR USE OF FIELD OFFICE TO THE CHIEF UNDERWRITER, OR ASSISTANT DIRECTOR SINGLE FAMILY MORTGAGE INSURANCE BRANCH: I have reviewed the foregoing and the pertinent 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 [] CHIEF ARCHITECTURAL SECTION J~DEPUTY FOR CHIEF ARCHIT. ECT HEALTH AUTHORITY APPROVAL FHA FORM NO. 2573- INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM R.ev. 11/71 666°1~6 0~9 Aq po~oadsuI -- 6I ' uo!loadsuT jo oleg 6I ' · olnm. m sod SUOlle~ · olnuTm aod SUOlIelg 'i~u!sso jo q~doQ · Kl!aoqlnv qlleOH i~oo-i [] ./lunoo [] 'aa, elS [] :,iq opera UOTlOOdsuI · ,iue JT ~sl[qTqxo poAoadde qlIm ~1dmso lou soop~ soop ~ uoDellelSuI 'uoildmnsuoo uemnq olep oa~ ,~soi. s! aomsu* JI 'o~ ~ .soX 'suolie~ '~lIo*deo 'XI~A~aD ~ 'omssoad~ :o~mols jo odX,i' · o~ ~ 'sox ~ :lqgIlaolem Eu!lunom dmnd 'oN ~ 'sox ~ :poulmp Xllodold mooadmnd ~!d dmnd ~ 'punoaB oaoqu osnoqdmnd ~ 'luomoseq jjo mooadmnd 'Xl~o~deo dmnd 'looj 'od!d doap jo qlguo~ 'llam dooG ~ 'llOm aXOlIeqS ~ :dmnd · IlIj~oeq Xamqpao ~ 'XelO polppnd ~ 'Ino~ ]uomoD ~ :qlln~ paluOS Buisea punoJe aoeds lo[Jolx~ 'loaJ jo qldop o] lq~Ilaol~ pol~OS aplolX olemlxoaddV 'looj ~ilOm ul JOlem jo lOaOi guldmnd oI qldop olum~oaddV 'Bulseo jo odA~ 'looj -- 'qldop Ielo~ 'soqou[ -- 'aolomel~ :uo!~nalsuo* IlOg 'uo!~nllod olqIssod jo sooanos aoqlo flooJ 'loodssoo ~looJ "pio~j iesods!p ~]ooj -- t~u*l o~Idos ~looj ~aeoa~ 'opls ~ ~luoaj~ ]u oui[ 1oI Isoa~ou ~looJ 'uo!lepunoj gu!pun~ :moji IlO~ lo oaums~0 · [io~x poao~ ~ 'iio~ ~nG ~ 'ilom UOA!J~ ~ 'IlO~ PalITJ~ ~ Imolj Xlddns aolen~ ienplA~pui ~OU~l ~laodoad ¢uoal moaj ~oeq los gellIOm~ .doop ]ooj -- 'smo~sXs i~sods!p-oB~mos pus Xlddns-lo~m [enp!a!pu! q~oq q~!m padoloaop Bu!oq lou aae~ oae~ pooqaoqq~!ou u! soi~aodoad ao:~eta jo ,ilddns o~,enbope qsTuanJ ol ,ilTU!.o!A ale!porous! u! si[om jo o~nl!*J jo paoooa ~uoooa lsom o^!o 'pooqaoqqgToU uT ,~molsno ~,ou sou [] oa~ [] SllOm IenpTa!pui 'soqou! 'u!eux JO az!il 'IooJ 'uTem JOlS~ oTIqnd lso~eou oh oouels!([ V'/::IIS,LS XlddrlS-8:llYM 'IYflOIAIONI - NOIID::IdSNI gO l~Od3~t (elH,I,) ,iq po:losdsuI -- 6I ' uo!loodsu! jo 'soqou! 'soqoul 'looj oxunbs. 'looj 'SUOlI~ll 'qldop pTnb!'I 'losj 'qlP!~ op!suI 'IooJ 0, uoml:edmoo lolu! `illouds:D 'sUOllS~ s~,uomlaeclmoo jo JoqmnbI 'lST~Olelfil 'looJ 'Ioodsso;D [] '~ue:l oDdos [] ~glg/$ qVSOdSICI-:IOV/~gS 'IVflOIAIONI - NOIID::IdSNI -10 IMOd:a~ 'llOm mo:j aouelSTG :loodssaD 'qlguoI oplsuI ~`il!oudeo p!nb!i ielo,L jo sls!suoo IN]WlV]~I 3,1gVWISd 3, 5. c// (Fill out in Triplicate) Name ,of person requesting approval, ~a~~ ~wner Le~.~, description. ~ /~/ , Number<of ~edrooms in house Water Analysis: a. Bactemial b. Detemgent Well data: Type . Dis:ance from well to closest existing or prooos~d: 3. Seepage Area 4, Cesspool' 5. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. b. Septic tank capacity in gallons c. Name of septic tank .manufactu~e.'r 1. If "home made" show diagram on reverse side of this form. Disposal field or seepage pit size and type ~ ~'~~ / 1, Distance to property llne to house ou~dat ~on e, Percolation Test results f. Percolation Test per-formed by Use the reverse .side of this form to show diagram, Diagram sh.~ula include '~the following infommaticm: p.roperty lines~ .well location, house location, ~ptic tank location, disposal area location~ location of percolation test, and direction of ground slope. 9. The information on this form is true an{~ correct to the best of my knowledge. %i'~>n'.eture 'of Applicant Date TO BE FILLED OUT BY HEALTH DEPART~4ENT PEBSONNEL ~he ~bove described sanitaz,y facilities are hereby approved, subject to the .......... ~i'l!owin? con~ki~.ions: ....... Conditions: ~ ~ The above described sanitary facilities sre dissppmoved for the following ;C'E~aS O~ S D~e Approval is valid for one year followir~g the date of approval. CPJ:cw ALASKA GEOLOGICAL CONSULTANTS TELEPHONE: 272-4114 ENGINEERING GEOLOGY '~ MINING ~ GEOPHYSICS ~ GROUNDWATER ~' PETROLEUM 2227 SPENArD ROAD ANCHORAGE, ALASKA 99503 April 21, 1969 Mr. E. D. Slack P. O. Box 713 Anchorage, Alaska 99501 Re: Percolation Test at 2500 West 67th Street, Anchorage, Alaska Dear Mr. Slack: This letter is to certify that a percolation test bas been conducted on the above-mentioned property. The test was performed in a six-inch diameter, twelve-inch deep test pit, located in the area of the proposed absorption field. Location of the test pit, the log and percolation data are shown on the attached sheet. This test was made in accordance with the Greater Anchorage Area Borough Health Department specifications as prescribed in Appendix B of the National Plumbing Code, 1962 Revision. Respectfully submitted, ALASKA GEOLOGICAL CONSULTANTS BGP:js Bruce G. Purcell Attach. BY .......... ~..~ .................. DATE ..................... C~KD. pY,.~.....DATE ................... -0 ,4' t TELEPHONE: 272-4114 ALASKA GEOLOGICAL CONSULTANTS ENGINEERING GEOLOGY ~ MINING ~ GEOPHY$1GS ~' GROUNDWATER ~ PETRO~..EUM 2227 SPENArD ROAD ANCHORAGE, ALASKA 99503 April 17, 1969 Mr. E. D. Slack P. O. Box 713 Anchorage, Alaska 99501 Re: Percolation Test at 2500 West 67th Street, Anchorage, Alaska Dear Mr. Slack: This letter is to certify that a percolation test has been conducted on the above-mentioned property. The test was performed in a six-inch diameter, twelve-inch deep test pit, located in the area of the proposed absorption field. Location of the test pit, the log and percolation data are shown on the attached sheet. This test was made in accordance with the Greater Anchorage Area Borough Health Department specifications as prescribed in Appendix B of the National Plumbing Code, 1962 Revision. Respectfully submitted, ALASKA GEOLOGICAL CONSULTANTS Bruce G. Purcell BGP:j s Attach. BY~ ........ .'. ....................... DAT£ ..................... ~r~9. ~'Y.....~ .......... DATE ..................... SHEET NO .................... OF ................. JOB NO ................................................. P~:RCOLAT7 ¢~ 505 WEST NORTHERN LIGHTS BOULEVARD ANCHORAGE, ALA. SKA 99503 PHONE 277--3581 April 14~, 19~9. Greater Anchorage Borough Health Dept. 327 Eagle~ Anchcrage~ Alaska. Attention: Mr. David B. Sanitarian Subject: Slack Residence Dear Mr. Harkness: This is to advise you that our Real Estate Broker Employment Contract dated 1-27-69, Cover- lug Lots 19 and 20~ Block 4~ Southwood Park, Anchorage, Alaska, states that there is a septic tank installed. In our discussion wish the seller, Mr. Bill W. Valentines he stated that he did net know the exact size. However, it was the required capacity for si~gle family dwelling. , .' Sincerely HOLLIS F. GAMEL ~ECEIPT FOR CERTIFIED MAIL--30~ (plus postage) POSTMARK SENT TO OR DATE STREET AND NO. P.O,, STATE AND ZIP CODE OPTIONAL SERVICES FOR ACDITIONAL FEES ' RETURN ~. 1. Shows to WhOm and date delivered ........... 15¢ With delivesy to addressee only ............ 65¢ RECEIPT p 2. Shows to whom~-date and where delivered .. 35¢ SERVICES With delivery to addressee only ............ 85~ DELIVER TO ADDRESSEE ONLY ...................................................... SPECIAL DELIVERY (extra fee required) .................................... PS Form NO ~ISURANCE COVERAGE PROVIDED-- (See other side) Apr. 1971 3800 NOT FOR INTERNATIONAL MAIL ~0Po:1972 o-46o-'~43 Tax Code: GREATEL ANCHORAGE AREA BOROUGH DYE TEST Date: Mailin~ Address: User / Tenant: Address: Subdivision: I!OCk [Lot DYE TEST: [] Pos/five . ~.. Negative ADDITIONAL INFORMATION: F/eld: Administered By; .i PW-062 (7-74)