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Home My WebLink AboutHANSEN SAND LAKE LT 6A G,r-'\TER ANCHORAGE AREA BORO'' --,�H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM 220 MAILING NAME 60M:;� ADDRESS P H 0 N E=2- '7� 'e _!,7 S"' LOCATION -LEGAL DESCRIPTION 14�1 C=f)Tlf- TAKIV j DISTANCE FROM WELL MATERIAL NUMBER OF COMPARTMENTS. _5_1725�7_ X�_7_;�l LIQUID LIQUID CAPACITY _Za 1�20 —GALLONS. INSIDE LENGTH INSIDE WIDTH—DEPTH— SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS -OLITSIDE DIAMETER OR WIDTH LENGTH DEPTH LINING MATERIAL DISTANCE FROM WELL BUILDING FOUNDATION__e�-5�� NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELI NUMBER OF LINES ABSORPTIO STANCE BETWEEN FT. LENGTH OF NEAREST LOT LIN TRENCH OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WELL: �/ DISTANCE FROM WATER A/,o TYPE DEPTH— JUILDING FOUNDATION.. SAMPLE , NEAREST I NEAREST —SEPTIC SEEPAGE __�OTHER LOT LINE SEWER LINE— TANK!___Z �-S, SYSTEM— CESSPOOL—, SOURCES�z niA(-.PAM OF SYSTEM DATE APPRO DISTANCES: DATE APPRO GAAB-H,D-2 GREATEI ANCHORAGE AREA HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT )ROUGH NAME OF APPLICANT RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK .7//- MAILING ADDRESS :Z¢///~~'/ PHONE NO. LOCATION OF INSTALLATION -:~ SEEPAGE PiT ~ ,DRAIN FIELD ,OTHER TO SERVE THE FOLLOWING FACILITY ~ .-~.~_~/Z/~,~, FINANCED THROUGH ~'~'-~-~-~ TO BE INSTALLED BY PERCOLATION TEST RESULT .~-~'(~'~z''~'f'~z~'/~''~ ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS/'?-"¥/~. ,_/~/~_~)///~.~?Z~ , PERMIT TO INSTALL A ~~ ~~ AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ,. SEPTIC TANK SIZE ~/J/) TYPE~~ SEEPAGE AREA DIAGRAM OF SYSTEM DISTANCES: HEALTH AUTHORITY OR LICENSED DESIGNER above described system is in accordance with said code. /~,B-HD-I GREATER ANCHORAGE AREA BORO~'~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING 730 ~*~' ADDRESS LEGAL DESCRIPTION Za~ SEPTIC TANK: LIQUID CAPACITY /~)C~ O GALLONS. MATERIAL NUMBER OF / COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH SEEPAGE SYSTEM: NUMBER OF PITS / LINING MATERIAl ~/~ NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH D,STANCE EROM EJi7/ TOTAL EFFECTIVE ABSORPI:ION AREA (WALL AREA) ,LENGTH qO , DEPTH , BUILDING FOUNDATION ~.? ,~ y SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELl , FOUNDATION. ., NEAREST LOT LINE NUMBER OF LINES DISTANCE BETWEEN LINES_ .TRENCH WIDTH ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH , OF LINES IN. TO]AL EFFECTIVE IN. ABOVE TILE__ WELL: DISTANCE FROM WATER TYPE DEPTH , BU LDING FOUNDATION SAMPLE NEAREST SEPTIC SEEPAGE LOT LINE ~ SEWER LINE , TANK SYSTEM , CESSPOOL NEAREST OTHER SOURCES DISTANCES: t J/71 DIAGRAM OF SYSTEM DATE _ )ROUGH Case No. t~EALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT ~-"~ RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH /~-'/-~' '4 ~N TEST RESULTS /~5' ~~ ANTICIPATED DATE OF COMPLETION MAILING ADDRESS 7~)~g~/, 7~2 PHONE NO.~:;Y¢~c-gSJ..~.' LOCATION OF ,NSTALLAT'O~: ~ ~¢' .C<~ ¢~.,~/,/ .... ,SEEPAGE PIT. //'"/ , DRAIN FIELD , OTHER BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS /~/~' //~/Z)"4~//"Z~)~7'~> , PERMIT TO INSTALL A .AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED . SEPTIC TANK SIZE /~:2~ TYPE ~TL~c~/ SEEPAGE AREA DIAGRAM OF SYSTEM Authority / 5-0 [ certify that ] am £amiHa~ with the ~equkeme~ts of Greate~ Anchorage Area Borough Ordinance No. 28-68 and that the tbove described system is in accordance with said code. /~~ GREAT_RANCHOS\GE AREA BOROUGi HEALTH DEPARTMENT /~27 EAGLE STREET ~NCHORAGE, ALASKA 99501 CASE # Performed For .~aek i,~"~ .. Legal Descrip{ion: Lot 6 Block This Form Reports a: Date Perfommed ~,,~m~ 7. 1969 _. Subdivision ~aas0n's Sand L~ke ~divisign Depth Feet Sell Chaz~a~eristics Overburden rpof, s, moss, e~c, 3 4 Sand~/' Gravel Reading Date Yes, At What bePth~ ~-- :'~i Gross Time Net T~me 8 lo Location Sketch DePih To H20 Net Drop ~ .: : Au~ 7--69 -~rcOla~i°h '.aTe' l"/: i[,/ P~oposed Instaliatl0n: Seepage Pit.~x , Depth Of Inlet Depth To Bottom COMMENTS: Date :_~,, 4t! DPain Field O':f' ~it Or '!'reneW' ' ~ .... FHA Form 2573 Rev. Jury 1958 FEOERAL HOUSING ADMINISTRATION HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM Form Approved Budget Bureau No. 63-R296.$ PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE MORTGAGOR OR SPONSOR Jack G. Lekander SUBDIVISION NAME Hansen Sand Lake SERIAL NO. 111:009236 PROPERTY ADDRESS 7310 Blackberryt Anchorage (HOUSE) TOTAL NUMBER: LIVING UNITS BEDROOMS 1 3 BATHS BASEMENT I-~] Yes ~1 No g New installation Can attic or other area bo mad~ into additional bedrooms? (If Yes, how martyr*) .[-]Yes j--J No WATER SUPPLY BY: [] Public system [] Community system ~-~ Individual SEWAGE DISPOSAL BY: [] Public system [] Community system [] Individual SYSTEM DESIGNED FOR NO. OF BDRM$. GARBAGE DISPOSAL []Yes DNa PART fl.--TO BE COMPLETED BY HEALTH DEPARTMENT qEALTH 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 satisfactory as a domestic water supply for the subject property. It is the opinion of the [] State [-'] County [~ Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: [-~ Can be expected to~eq~on satisfactorily, and ~] Cannot be expected to function satisfactorily is not likely to cre/~te an i~sanit~ condition /] DATE I ,~ G~=U~R~:///'/ ~ / ITM 10/8/70 J ~ anitarian NOTE: The he~K authority rhould, complete the appropriate opinion statement above and affix date, signature and title In the spaces pravldad~ Use of the above grid 'for Health Department Inspector's sketch as well as use of the back of this form Js at the option of the health authority. 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 JSIGNATURE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM [CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT FHA Form 2573 Rev. July 1958 '~aaj --61 · olnu!m Jad SUOl[~ '*mu!m .~ad suolNS '~'u!s~.~ jo q~daQ 'aU!l AlJadogd luo~j moJj ~puq las gU]llata(l 'daap laaj · smals,{s lesods!p-a~etaas puu Alddns-Jaluta lunp!^!pu] qloq ql!ta padolo^*p 8u!oq lou *Je [] aJu [] pooqJoqq~'!*u u! sapJ*doJd aaleta jo Alddns alunbape tis!mnJ ol ,hiup}a ale[patutu} ti! Slla~a jo aml}Uj jo pJo2aJ lua2aJ lsotu aa!D 'pooqioqqg!au u! lJuuJolsn.~ lou aJ}~ [] ;nu [] Slla^~ i~np!^!pul 'saq>uF 'u!utu jo az!s 'laaj 'mmu Ja~t* >Hqnd 3saseau m a.mms!C[ WtJ.SAS AlddNS-ii:t,LV/~ IVNQIAIONI--NOII~)ldSNI :lO J.~lOd3~ 's*q2u! 'saq~u! 'laoj 'laaj 61 uop.>adsu! jo aluCI -,iq po~:~lsuI '~aJ ~ 'apes ~ '~uoJj ~ ~s aaH ~oI ~sa~eau '.~aaj 'uop~punoj ~u~punq '.~aaj 'lla~ :mog a~ums~Q le~Ja~Um ~tqu~q 'laaj qlda~ 'laSt Jalam~}p ap~smO .... sl~d jo J~tunN 'laaj 'qldap p3nbH '~aqt 'qlp!t* ap!sul 'laaj 'luatu~Jedtuo> l,~lU! Al!>~du,D 'suollg,h' s~uatu)Jedtuo~ jo iaquJnN '[oodssaD [] '~uel ~pdaS [] jo s~s]suo~ iN:IWLV{IIJ. AllYWllld WmlSAS 'lV$OdSl(l-lOV/V~t$ IVFIOIAIGNI~NOIJ.:)ld~NI :lO lilOdllJ INDIVIDUAL SEWAGE AND WATER FACILITIES · of-person requestin~approval b. Detergent · " ..... 6~ .We]_l data: c. Casing Size Distance from well to closest existing or proposed: 1, Sewer line Cesspool' . 5. Property Line Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. , ..... · Sewage disposal system· a. Age of system. /~ ~ b. Septic tank capacity in gallons.. c. Name of septic tank manufactum~r 1. If "home made" show diagram on reverse side of this form. Disposal field, or seepa~t size and type _ . . .. 1. Dist.ance to proper~cy-. line. . to house fo~kndation e, Pemcolatio~ Tes~ A"esuJ_ts ~ f.' Percolation Test performed by ........... , ~ Use the reverse.side of this form to show diagram. Diafram should include · ....~_he following information: ~operty llnes;.well location, house location, ~aptic tank location, disposal area location, location of percolation test, a~...dlrection of ground slope. 9. The l~f-ox~nationon this form is true and correct to the best of my knowledge. ~ Signature of Applicant ~ate Signed TO BE FILLED OUT BY HEALTH DEPART!.!ENT PERSONNEL : e above described sanitary facilities are hereby approved subjec~ to the '"~'~'~'ilowin~ cond~o~s ~_ ' Con dit ions: The above described sanitary facilities are disspproved for the following reasons: '-~ .A~"pro~l is valid for one year following the date of approval. · .~ CPU: cw .